title: Lung function at one month of age as a risk factor for infant respiratory symptoms in a high risk population.
abstract: BACKGROUND
  Abnormal premorbid lung function is a risk factor for subsequent wheezing in children with one or no atopic parent. This study was undertaken to establish whether early lung function in high risk infants (both parents atopic) was a risk factor for respiratory symptoms in infancy and to examine the influence of maternal asthma, smoking, and allergen exposure during pregnancy on any association.
  
  
  METHODS
  Infants were recruited from the NAC Manchester Asthma and Allergy Study cohort at birth. Partial forced expiratory flow volume technique under sedation was carried out to determine maximal flow at FRC (V'maxFRC). Children were followed prospectively and parents completed a standard respiratory questionnaire at one year of age.
  
  
  RESULTS
  Sixty nine term infants (34 boys; 88% mothers non-smokers; no household pets) underwent respiratory function testing. Size adjusted V'maxFRC was significantly lower in infants who had recurrent wheeze during the first year of life (mean 1.3 ml/s/cm, 95% CI 0.99 to 1.60) than in those who did not (mean 2.03 ml/s/cm, 95% CI 1.71 to 2.36; p=0.01). V'maxFRC was also significantly lower in infants who had recurrent cough symptoms. In multivariate regression analysis, when adjusted for age at test, sex, maternal asthma, smoking and maternal mattress Der 1 levels, a lower size adjusted V'maxFRC score remained strongly associated with wheezing (OR 0.37, 95% CI 0.18 to 0.77, p=0.007). Maternal smoking also remained an independent risk factor (OR 29.85, 95% CI 2.46 to 362.5, p=0.008).
  
  
  CONCLUSIONS
  Significantly diminished lung function was present in high risk infants who subsequently wheezed and coughed. This was independent of maternal exposure to mite allergen, asthma, and smoking during pregnancy.
authors.affiliation: North West Lung Centre, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, UK.
authors.forename: C S
authors.initials: CS
authors.lastname: Murray
authors.forename: S D
authors.initials: SD
authors.lastname: Pipis
authors.forename: E C
authors.initials: EC
authors.lastname: McArdle
authors.forename: L A
authors.initials: LA
authors.lastname: Lowe
authors.forename: A
authors.initials: A
authors.lastname: Custovic
authors.forename: A
authors.initials: A
authors.lastname: Woodcock
mesh_terms: D003371:Cough / Q000503:physiopathology; D005260:Female; D005652:Functional Residual Capacity / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012135:Respiratory Sounds / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution