Respiratory illnesses in early life and asthma and atopy in childhood.
BACKGROUND
The relation between respiratory illnesses in early life and the development of asthma and atopy in childhood is incompletely understood.


OBJECTIVE
We sought to examine the relationship between respiratory illnesses in early life and atopic diseases at school age.


METHODS
We performed a prospective birth cohort study of the relationship between respiratory illnesses in the first year of life and asthma, atopy (sensitization to >or=1 allergen), and allergic rhinitis at school age in 440 children with a parental history of atopy. Logistic regression was used to examine the relationship between respiratory illnesses and asthma, atopy, and allergic rhinitis. The relationship between respiratory illnesses in early life and repeated measures of wheezing between the ages of 1 and 7 years was investigated by using a proportional hazards models.


RESULTS
Physician-diagnosed croup (adjusted odds ratio [OR], 0.30; 95% CI, 0.12-0.72) and having 2 or more physician-diagnosed ear infections (adjusted OR, 0.58; 95% CI, 0.35-0.98) in the first year of life were inversely associated with atopy at school age. Physician-diagnosed bronchiolitis before age 1 year was significantly associated with asthma at age 7 years (adjusted OR, 2.77; 95% CI, 1.23-6.22). Recurrent nasal catarrh (>or=3 episodes of a runny nose) in the first year of life was associated with allergic rhinitis at age 7 years (adjusted OR, 2.99; 95% CI, 1.03-8.67).


CONCLUSIONS
The relationship between early-life respiratory illnesses and asthma and atopy is complex and likely dependent on the type of infection and immune response it initiates.


CONCLUSIONS
Certain respiratory illnesses in early life modify the risk of atopy and asthma at school age.
Ramsey
Clare D
CD
Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.
Gold
Diane R
DR
Litonjua
Augusto A
AA
Sredl
Diane L
DL
Ryan
Louise
L
Celedón
Juan C
JC
D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000453:epidemiology*; D002648:Child; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000209:etiology; D012141:Respiratory Tract Infections / Q000453:epidemiology*; D012882:Skin Tests
D000485:Allergens; D007073:Immunoglobulin E