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Respiratory status and allergy nine to 10 years after acute bronchiolitis
Insights
Infants hospitalized with acute bronchiolitis often experience persistent coughing and wheezing later in childhood. These respiratory issues are linked to airway obstruction, not allergies.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Epidemiology
Background:
- Acute bronchiolitis in infancy is a common respiratory infection.
- Long-term respiratory sequelae following bronchiolitis are a significant concern.
- Previous studies suggest a link between early bronchiolitis and later respiratory problems.
Purpose of the Study:
- To investigate the long-term relationship between acute bronchiolitis in infancy and subsequent respiratory symptoms and lung function.
- To determine if atopy (allergic predisposition) contributes to these persistent respiratory issues.
Main Methods:
- Prospective follow-up of children previously hospitalized for bronchiolitis.
- Comparison with a matched control group.
- Assessment of respiratory symptoms, lung function tests (including spirometry and lung volumes), and atopy markers (family history, skin prick tests).
Main Results:
- Index children (former bronchiolitis patients) showed significantly higher rates of coughing and wheezing compared to controls.
- Lung function tests revealed reduced measures of airways obstruction (e.g., forced expiratory volume in one second) in index children.
- No significant differences in lung growth parameters or markers of atopy were found between the groups.
Conclusions:
- Acute bronchiolitis in infancy is associated with persistent respiratory symptoms and evidence of airways obstruction in later childhood.
- These long-term respiratory problems are not attributable to familial or personal susceptibility to atopy.
- Findings support bronchiolitis as a risk factor for chronic respiratory issues beyond infancy.
Abstract:
In order to evaluate further the relationship between acute bronchiolitis in infancy and subsequent respiratory problems, children prospectively followed up from the time of their admission to hospital were reviewed along with a group of matched controls recruited at the previous five and a half year assessment. Sixty one index children and 47 controls took part. The groups were well matched for age, height, parental smoking, and social class. Although the prevalence of respiratory symptoms had fallen when related to the previous review, there remained an excess of coughing (48 and 17% in index and control children respectively; odds ratio 4.02) and wheezing (34 and 13% in index and control children respectively; odds ratio 3.59). Bronchodilator therapy was used by 33% of index children compared with 3% of controls. Lung function tests revealed no significant differences in the measurements of lung growth-for example, forced vital capacity, functional residual capacity, and total lung capacity-but the index children had significant reductions in measurements of airways obstruction-for example, forced expiratory volume in one second, maximum expiratory flow at 75, 50 and 25% of vital capacity, and airways resistance. Family history and personal skin tests showed no excess of atopy in the index group. This study supports the claim that the excess respiratory symptoms after acute bronchiolitis are not due to familial or personal susceptibility to atopy.