Acute lower respiratory illness in childhood as a predictor of lung function and chronic respiratory symptoms.
This study investigated the relationship of acute lower respiratory illness (LRI) to level and change in level of forced expiratory volumes in a cohort of 801 children, followed longitudinally for a maximum of 13 yr. The co-occurrence of respiratory illness before 2 yr of age and two or more LRI during a single surveillance year was associated with a 20.3% lower mean cross-sectional level of FEF25-75, and with reduced longitudinal change in level of FEF25-75. The effect of LRI on lung function was uniformly stronger for boys than for girls. Of the children with illness before 2 yr of age and two or more LRI, six of 14 were male asthmatics with mean levels of FEF25-75 that were lower than those of other asthmatic children. Pneumonia and/or hospitalization for respiratory illness prior to the onset of study were associated with lower cross-sectional levels of forced expiratory volumes at entry to the study, even when asthmatics/persistent wheezers were eliminated from the analysis (6.1% lower level of FEV1 for a nonasthmatic boy with previous hospitalization versus a nonasthmatic boy without hospitalization). In the longitudinal analysis, pneumonia and/or hospitalization were associated with slower increase in level of forced expiratory volumes, even after adjusting for "ever diagnosis of asthma/current any wheeze" (starting at the same leve, after eight years a boy with hospitalization would develop a 5.0% lower FEV1 than a boy without hospitalization). Acute LRI also was evaluated as a predictor of chronic respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
Gold
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DR
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115.
Tager
I B
IB
Weiss
S T
ST
Tosteson
T D
TD
Speizer
F E
FE
D000208:Acute Disease; D001249:Asthma / Q000453:epidemiology; D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000150:complications* / Q000453:epidemiology; D008173:Lung Diseases, Obstructive / Q000209:etiology*; D008297:Male; D011014:Pneumonia / Q000453:epidemiology; D011336:Probability; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014797:Vital Capacity