Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age.
OBJECTIVE
To compare airway function in early adulthood in subjects with wheezing in infancy with age-matched controls and to analyze what accounts for a possible difference.


METHODS
Asthma development has been prospectively studied in 101 children hospitalized due to wheezing before the age of two. The cohort was re-investigated at age 17-20 years and tested with spirometry and for bronchial hyper-responsiveness and allergic sensitization. An age-matched population (n = 294) was used for comparison.


RESULTS
The cohort had a significantly lower FEV(1)/FVC ratio and MEF(50), both pre- and post-bronchodilation, compared with the controls, P < 0.01. The reduction in airway function was most evident in current asthmatic female subjects, but a reduced pre-bronchodilation FEV(1)/FVC ratio was also seen in symptom-free cohort subjects, P = 0.03. In the multivariate analysis, female gender was the most prominent independent risk factor for reduced airway function in early adulthood, pre-bronchodilation OR 4.0 (1.4-11.3) and post-bronchodilation OR 8.8 (1.8-42.0). In addition, a history of early wheezing, that is, belonging to the cohort, was an independent risk factor for reduced airway function pre-bronchodilation, OR 3.3 (1.3-8.7). Furthermore, there was an association between current bronchial hyper-responsiveness and an increased risk of reduced airway function post-bronchodilation, OR 7.3 (2.0-26.6).


CONCLUSIONS
Reduced airway function in early adulthood was found in subjects with wheezing early in life, compared with age-matched controls. The reduction was most prominent in females with current asthma.
Goksör
Emma
E
Department of Paediatrics, Göteborg University, Queen Silvia Children's Hospital, Göteborg, Sweden. emma.goksor@vgregion.se
Gustafsson
Per M
PM
Alm
Bernt
B
Amark
Mainor
M
Wennergren
Göran
G
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D007223:Infant; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008448:Maximal Expiratory Flow Rate; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000503:physiopathology; D012307:Risk Factors; D017678:Sex Distribution; D013147:Spirometry; D013995:Time; D014028:Tobacco Smoke Pollution / Q000009:adverse effects; D014797:Vital Capacity
D014028:Tobacco Smoke Pollution