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Asthma and lung function 20 years after wheezing in infancy: results from a prospective follow-up study.
Arch Pediatr Adolesc Med 2004; 158(11):1070-6AP

Abstract

OBJECTIVE

To determine the outcome until adulthood after wheezing in infancy, compared with pneumonia in infancy and with controls.

DESIGN

An 18- to-20-year prospective cohort study.

SETTING

Pediatric department at a university hospital, providing primary hospital care for a defined population. Patients Fifty-four children hospitalized for bronchiolitis and 34 for pneumonia at younger than 2 years, and 45 controls with no early-life wheezing or hospitalization, were studied at median age 19 years.

MAIN OUTCOME MEASURES

A questionnaire on asthma symptoms and medication, physical examination, flow volume spirometry (FVS), methacholine inhalation challenge (MIC), home peak expiratory flow (PEF) monitoring, and skin prick testing (SPT) to common inhalant allergens. The 2 asthma definitions were physician-diagnosed asthma and previously diagnosed asthma with recent asthmatic symptoms (physician-diagnosed asthma included).

RESULTS

By the 2 definitions, asthma was present in 30% (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.12-10.10) and in 41% (OR 1.38; 95% CI, 0.37-5.21) in the bronchiolitis group, in 15% (OR, 5.50; 95% CI, 1.87-16.14) and in 24% (OR, 2.07; 95% CI, 0.59-7.22) in the pneumonia group, and in 11% in the control group. After bronchiolitis, the FVS values were forced vital capacity (FVC), 108% (SD, 13%) of predicted; forced expiratory volume in 1 second, 98% (SD, 12%); forced expiratory volume in 1 second divided by FVC, 91% (SD, 7.6%); midexpiratory flow at 50% of the FVC, 74% (SD, 19%); and midexpiratory flow at 25% of the FVC, 74% (SD, 22%). Bronchial reactivity by MIC was present in 25 (48%) of 52 subjects in the bronchiolitis group, in 13 (42%) of 31 in the pneumonia group, and in 14 (32%) of 44 in the control group. The prevalence of atopy (positive SPTs) was 48% to 63% in the 3 groups. In a logistic regression adjusted for atopy and smoking, infantile bronchiolitis was an independent risk factor for asthma by both definitions.

CONCLUSION

The increased risk for asthma persists until adulthood after bronchiolitis in infancy.

Authors+Show Affiliations

Department of Pediatrics, Kuopio University Hospital, and Kuopio University, Kuopio, Finland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15520345

Citation

Piippo-Savolainen, Eija, et al. "Asthma and Lung Function 20 Years After Wheezing in Infancy: Results From a Prospective Follow-up Study." Archives of Pediatrics & Adolescent Medicine, vol. 158, no. 11, 2004, pp. 1070-6.
Piippo-Savolainen E, Remes S, Kannisto S, et al. Asthma and lung function 20 years after wheezing in infancy: results from a prospective follow-up study. Arch Pediatr Adolesc Med. 2004;158(11):1070-6.
Piippo-Savolainen, E., Remes, S., Kannisto, S., Korhonen, K., & Korppi, M. (2004). Asthma and lung function 20 years after wheezing in infancy: results from a prospective follow-up study. Archives of Pediatrics & Adolescent Medicine, 158(11), pp. 1070-6.
Piippo-Savolainen E, et al. Asthma and Lung Function 20 Years After Wheezing in Infancy: Results From a Prospective Follow-up Study. Arch Pediatr Adolesc Med. 2004;158(11):1070-6. PubMed PMID: 15520345.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Asthma and lung function 20 years after wheezing in infancy: results from a prospective follow-up study. AU - Piippo-Savolainen,Eija, AU - Remes,Sami, AU - Kannisto,Senja, AU - Korhonen,Kaj, AU - Korppi,Matti, PY - 2004/11/3/pubmed PY - 2004/12/16/medline PY - 2004/11/3/entrez SP - 1070 EP - 6 JF - Archives of pediatrics & adolescent medicine JO - Arch Pediatr Adolesc Med VL - 158 IS - 11 N2 - OBJECTIVE: To determine the outcome until adulthood after wheezing in infancy, compared with pneumonia in infancy and with controls. DESIGN: An 18- to-20-year prospective cohort study. SETTING: Pediatric department at a university hospital, providing primary hospital care for a defined population. Patients Fifty-four children hospitalized for bronchiolitis and 34 for pneumonia at younger than 2 years, and 45 controls with no early-life wheezing or hospitalization, were studied at median age 19 years. MAIN OUTCOME MEASURES: A questionnaire on asthma symptoms and medication, physical examination, flow volume spirometry (FVS), methacholine inhalation challenge (MIC), home peak expiratory flow (PEF) monitoring, and skin prick testing (SPT) to common inhalant allergens. The 2 asthma definitions were physician-diagnosed asthma and previously diagnosed asthma with recent asthmatic symptoms (physician-diagnosed asthma included). RESULTS: By the 2 definitions, asthma was present in 30% (odds ratio [OR], 3.37; 95% confidence interval [CI], 1.12-10.10) and in 41% (OR 1.38; 95% CI, 0.37-5.21) in the bronchiolitis group, in 15% (OR, 5.50; 95% CI, 1.87-16.14) and in 24% (OR, 2.07; 95% CI, 0.59-7.22) in the pneumonia group, and in 11% in the control group. After bronchiolitis, the FVS values were forced vital capacity (FVC), 108% (SD, 13%) of predicted; forced expiratory volume in 1 second, 98% (SD, 12%); forced expiratory volume in 1 second divided by FVC, 91% (SD, 7.6%); midexpiratory flow at 50% of the FVC, 74% (SD, 19%); and midexpiratory flow at 25% of the FVC, 74% (SD, 22%). Bronchial reactivity by MIC was present in 25 (48%) of 52 subjects in the bronchiolitis group, in 13 (42%) of 31 in the pneumonia group, and in 14 (32%) of 44 in the control group. The prevalence of atopy (positive SPTs) was 48% to 63% in the 3 groups. In a logistic regression adjusted for atopy and smoking, infantile bronchiolitis was an independent risk factor for asthma by both definitions. CONCLUSION: The increased risk for asthma persists until adulthood after bronchiolitis in infancy. SN - 1072-4710 UR - https://www.unboundmedicine.com/medline/citation/15520345/Asthma_and_lung_function_20_years_after_wheezing_in_infancy:_results_from_a_prospective_follow_up_study_ L2 - https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/archpedi.158.11.1070 DB - PRIME DP - Unbound Medicine ER -