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Published on: August 7, 2017
Association between severe bronchiolitis in infancy and age 6-year lung function
Geneva D Mehta1, Anna Chen Arroyo2, Zhaozhong Zhu3
1Brigham and Women's Hospital, Boston, MA, USA.
Insights
Severe infant bronchiolitis is linked to reduced lung function by age six. This early life respiratory illness may increase the risk of chronic lung disease later in life.
Area of Science:
- Pediatric Pulmonology
- Respiratory Epidemiology
- Childhood Respiratory Health
Background:
- Early life respiratory infections are a significant public health concern.
- Identifying risk factors for diminished lung function is crucial for lifelong respiratory health.
- Severe bronchiolitis in infancy is a potential risk factor for long-term pulmonary outcomes.
Purpose of the Study:
- To investigate the association between severe (hospitalized) bronchiolitis in infancy and lung function at age 6.
- To determine if early life respiratory illness impacts lung development.
- To provide data for early intervention strategies to improve lung health.
Main Methods:
- Analysis of two prospective cohort studies: infants hospitalized with bronchiolitis and a healthy infant cohort.
- Longitudinal follow-up with spirometry performed at age 6 years.
- Multivariable linear regression models adjusted for key covariates (e.g., socioeconomic status, environmental exposures, genetics) to assess primary outcomes: FEV1% predicted (pp) and FEV1/FVCpp.
Main Results:
- Spirometry data at age 6 were available for 425 children with a history of severe bronchiolitis and 48 controls.
- Children with a history of severe bronchiolitis exhibited significantly lower FEV1pp (8% lower, p=0.004) and FEV1/FVCpp (4% lower, p=0.007) compared to controls, even after adjustment.
- No significant differences were observed in FVCpp or bronchodilator responsiveness (BDR) between the groups.
Conclusions:
- Infants hospitalized with severe bronchiolitis demonstrate reduced FEV1 and FEV1/FVC at age 6.
- These findings suggest a potential increased risk for chronic respiratory conditions later in life in children with a history of severe infant bronchiolitis.
- Early life respiratory health interventions may be warranted for infants experiencing severe bronchiolitis.
Background And Objectives:
Understanding early life risk factors for decreased lung function could guide prevention efforts and improve lung health throughout the lifespan. Our objective was to investigate the association between history of severe (hospitalized) bronchiolitis in infancy and age 6-year lung function.
Methods:
We analyzed data from two prospective cohort studies: infants hospitalized with bronchiolitis and a parallel cohort of healthy infants. Children were followed longitudinally, and spirometry was performed at age 6 years. To examine the relationship between history of severe bronchiolitis and primary outcomes - FEV1% predicted (pp) and FEV1/FVCpp - we used multivariable linear regression models adjusted for insurance status, perterm birth, secondhand smoke exposure, breastfeeding status, traffic-related air pollution and polygenic risk score. Secondary outcomes included FVCpp and bronchodilator responsiveness (BDR).
Results:
Age 6-year spirometry was available for 425 children with history of severe bronchiolitis in infancy and 48 controls. Unadjusted analysis revealed that while most children had normal range lung function, children with a history of severe bronchiolitis had lower FEV1pp and FEV1/FVCpp. In adjusted analyses, the same findings were observed: FEV1pp was 8% lower (p = 0.004) and FEV1/FVCpp was 4% lower (p = 0.007) in children with history of severe bronchiolitis versus controls. FVC and BDR did not differ between groups.
Conclusions:
Children with severe bronchiolitis in infancy have decreased FEV1 and FEV1/FVC at age 6 years, compared to controls. These children may be at increased risk for chronic respiratory illness later in life.
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