title: Determinants of baseline lung function and bronchodilator response in 4-year-old children.
abstract: The prolonged period required for maturation of the respiratory system makes it vulnerable to environmental exposure. This study aimed to investigate the association between early-life factors and lung function in preschool children. Children aged 4 years, who were included in a prospective birth cohort, underwent lung function testing at baseline (n=535) and after bronchodilation (n=498) by forced oscillations. Information on symptoms and exposures was collected through half-yearly questionnaires. Allergen-specific serum IgE was quantified at 1 and 4 years. Multiple linear regression analysis showed that the baseline respiratory resistance and reactance area were larger in the children with previous wheeze, those with early-onset sensitisation to inhalant allergens and those who were smaller. Furthermore, children with previous lower respiratory tract infections exhibited higher baseline resistance values. The baseline resistance was the only independent determinant of the bronchodilator-induced change in resistance, whereas current height and baseline reactance area were independently associated with the change in reactance area. In conclusion, previous lower respiratory tract infections, the timing of previous wheeze, inhalant sensitisation and current height independently influence the baseline lung function of 4-year-old children, whereas baseline lung function is the principal determinant of the bronchodilator response.
authors: Dept of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
authors: Sandra
authors: S
authors: Dom
authors: Dept of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
authors: Joost J
authors: JJ
authors: Weyler
authors: Dept of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
authors: Jos H J
authors: JH
authors: Droste
authors: Dept of Paediatrics, Antwerp University Hospital, Antwerp, Belgium Dept of Immunology, Allergology and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
authors: Margo M
authors: MM
authors: Hagendorens
authors: Dept of Paediatrics, Antwerp University Hospital, Antwerp, Belgium.
authors: Elke
authors: E
authors: Dierckx
authors: Dept of Immunology, Allergology and Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
authors: Chris H
authors: CH
authors: Bridts
authors: Dept of Pulmonary Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.
authors: Wilfried
authors: W
authors: De Backer
authors: Dept of Pulmonary Medicine, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium ellie.oostveen@uza.be.
authors: Ellie
authors: E
authors: Oostveen
mesh_terms: D000485:Allergens / Q000276:immunology; D000886:Anthropometry; D001993:Bronchodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002675:Child, Preschool; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D008168:Lung / Q000187:drug effects* / Q000502:physiology*; D008297:Male; D009991:Oscillometry; D011446:Prospective Studies; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D011795:Surveys and Questionnaires
chemical_list: D000485:Allergens; D001993:Bronchodilator Agents; D007073:Immunoglobulin E