title: Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness.
abstract: Lower respiratory tract illness is a major cause of childhood morbidity and mortality. It is unknown whether infants are predisposed to illness because of impaired lung function or whether respiratory illness reduces lung function.
  
  
  
  To investigate the impact of early life exposures, including lower respiratory tract illness, on lung function during infancy.
  
  
  
  Infants enrolled in the Drakenstein child health study had lung function at 6 weeks and 1 year. Testing during quiet natural sleep included tidal breathing, exhaled nitric oxide, and multiple breath washout measures. Risk factors for impaired lung health were collected longitudinally. Lower respiratory tract illness surveillance was performed and any episode investigated.
  
  
  
  Lung function was tested in 648 children at 1 year. One hundred and fifty (29%) infants had a lower respiratory tract illness during the first year of life. Lower respiratory tract illness was independently associated with increased respiratory rate (4%; 95% confidence interval [CI], 1.01-1.08; P = 0.02). Repeat episodes further increased respiratory rate (3%; 95% CI, 1.01-1.05; P = 0.004), decreased tidal volume (-1.7 ml; 95% CI, -3.3 to -0.2; P = 0.03), and increased the lung clearance index (0.13 turnovers; 95% CI, 0.04-0.22; P = 0.006) compared with infants without illness. Tobacco smoke exposure, lung function at 6 weeks, infant growth, and prematurity were other independent predictors of lung function at 1 year.
  
  
  
  Early life lower respiratory tract illness impairs lung function at 1 year, independent of baseline lung function. Preventing early life lower respiratory tract illness is important to optimize lung function and promote respiratory health in childhood.
authors: 1 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, and.
authors: Diane M
authors: 0000-0002-7712-6774
authors: DM
authors: Gray
authors: 2 Telethon Kids Institute and Centre for Child Health, University of Western Australia, Perth, Australia.
authors: Lidija
authors: L
authors: Turkovic
authors: 1 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, and.
authors: Lauren
authors: L
authors: Willemse
authors: 1 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, and.
authors: Ane
authors: A
authors: Visagie
authors: 1 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, and.
authors: Aneesa
authors: A
authors: Vanker
authors: 3 Department of Psychiatry, University of Cape Town, Cape Town, South Africa.
authors: Dan J
authors: DJ
authors: Stein
authors: 4 Children's Lung, Environment and Asthma Research, Child Health Research Centre, University of Queensland and Queensland Children's Medical Research Institute, Brisbane, Australia; and.
authors: Peter D
authors: PD
authors: Sly
authors: 2 Telethon Kids Institute and Centre for Child Health, University of Western Australia, Perth, Australia.|5 School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
authors: Graham L
authors: GL
authors: Hall
authors: 1 Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and MRC Unit on Child and Adolescent Health, and.
authors: Heather J
authors: HJ
authors: Zar
mesh_terms: D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008168:Lung / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D012129:Respiratory Function Tests; D056152:Respiratory Rate; D012140:Respiratory Tract Diseases / Q000503:physiopathology*; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013990:Tidal Volume; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D014028:Tobacco Smoke Pollution
keywords: LRTI; epidemiology; infant; lung function; lung growth and development