Early life environmental control: effect on symptoms, sensitization, and lung function at age 3 years.
We investigated whether environmental control during pregnancy and early life affects sensitization and lung function at the age of 3 years. High-risk children (n = 251) were prenatally randomized to stringent environmental control (active) or no intervention (control). Questionnaires, skin testing, IgE, and specific airway resistance (sRaw) measurement were completed at the age of 3 years. Children in the active group were significantly more frequently sensitized compared with control subjects (at least one allergen by skin tests: risk ratio, 1.61; 95% confidence interval [CI], 1.02-2.55; p = 0.04; mite by IgE: risk ratio, 2.85; 95% CI, 1.02-7.97; p = 0.05). However, sRaw was significantly better in the active group (kiloPascal/second, geometric mean [95% CI]: 1.05 [1.01-1.10] vs. 1.19 [1.13-1.25], p < 0.0001, active vs. control). Maximal flow at functional residual capacity was measured using rapid thoracic compression at the age of 4 weeks in a subgroup. Prospective lung function data (at infancy and 3 years) were obtained in 32 children (14 active and 18 control). There was no difference in infant lung function between the groups, but at 3 years, sRaw was significantly lower in the active compared with control children (p = 0.003). Stringent environmental control was associated with increased risk of mite sensitization but better results for some measurements of lung function in high-risk children at the age of 3 years.
Woodcock
Ashley
A
North West Lung Centre, Wythenshawe Hospital, Manchester M23 9LT, UK.
Lowe
Lesley A
LA
Murray
Clare S
CS
Simpson
Bridget M
BM
Pipis
Spyros D
SD
Kissen
Patricia
P
Simpson
Angela
A
Custovic
Adnan
A
D000485:Allergens / Q000032:analysis*; D002675:Child, Preschool; D015897:Comorbidity; D004391:Dust / Q000032:analysis; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D007073:Immunoglobulin E / Q000097:blood; D007231:Infant, Newborn; D008173:Lung Diseases, Obstructive / Q000453:epidemiology / Q000276:immunology; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012129:Respiratory Function Tests; D006113:United Kingdom / Q000453:epidemiology
D000485:Allergens; D004391:Dust; D007073:Immunoglobulin E