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Lung function at school age in infants with lower respiratory tract infections with and without wheezing: A birth

Franca Rusconi1,2, Enrico Lombardi3, Elena Spada1

  • 1Division of Epidemiology, Meyer Children's University Hospital, Florence, Italy.

Pediatric Pulmonology
|January 20, 2022
PubMed

Insights

Infants experiencing both lower respiratory tract infections (LRTI) and wheezing in early childhood show reduced lung function by school age. LRTI alone did not significantly impact lung function development.

Area of Science:

  • Pediatric Pulmonology
  • Epidemiology
  • Respiratory Health

Background:

  • Early childhood lower respiratory tract infections (LRTI) are common and may impact long-term respiratory health.
  • The combined effect of LRTI and wheezing in infancy on subsequent lung function is not fully understood.

Purpose of the Study:

  • To investigate the association between LRTI in the first two years of life and lung function at school age.
  • To differentiate the impact of LRTI alone versus LRTI combined with wheezing on lung function outcomes.

Main Methods:

  • Prospective birth cohort study (Piccolipiù, Italy) including 877 children.
  • LRTI and wheezing data collected via parental questionnaires during the first two years of life.
  • Spirometry assessed lung function (FVC, FEV1, FEV1/FVC, FEF25-75, FEF75) at age seven; results reported as Z-scores.
  • Linear regression models used to analyze associations between early-life respiratory events and lung function.

Main Results:

  • Children with a history of both LRTI and wheezing exhibited significantly reduced lung function across all spirometric measures compared to those with neither condition.
  • Specifically, children with both LRTI and wheezing showed inverse associations with Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), FEV1/FVC ratio, and mid-expiratory flow rates (FEF25-75, FEF75).
  • Children with LRTI only did not show a significant association with reduced lung function at school age.

Conclusions:

  • The presence of wheezing alongside LRTI in infancy is a critical factor associated with diminished lung function at school age.
  • LRTI alone in early childhood does not appear to have a lasting negative impact on lung function development.
  • These findings highlight the importance of identifying and managing infants with combined wheezing and LRTI to potentially mitigate long-term respiratory consequences.
Abstract

Keywords:
bronchiolitisbronchitischildpneumoniaspirometry

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