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Early-life respiratory tract infections and risk of lower lung function and asthma at school-age. The generation R study

Evelien van Meel, Herman T. den Dekker, Niels J. Elbert, Henriëtte A. Moll, Irwin K. Reiss, Johan C. de Jongste, Vincent W.V. Jaddoe, Liesbeth Duijts
European Respiratory Journal 2016 48: PA3134; DOI: 10.1183/13993003.congress-2016.PA3134
Evelien van Meel
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, Netherlands
2Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
3Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Herman T. den Dekker
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, Netherlands
2Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
3Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Niels J. Elbert
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, Netherlands
4Department of Dermatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Henriëtte A. Moll
5Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Irwin K. Reiss
6Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Johan C. de Jongste
2Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Vincent W.V. Jaddoe
1The Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, Netherlands
3Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
5Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Liesbeth Duijts
2Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
3Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
6Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Abstract

Background: Early-life respiratory tract infections could lead to higher airway sensitization affecting airway obstruction and hyperreactivity, and subsequently asthma in later life.

Aim: We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children.

Methods: This study among 5,388 children was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections was obtained by questionnaires from age 6 months to 6 years and grouped into respiratory tract infections ≤3 and >3 years. At age 10 years FEV1, FVC, FEV1/FVC and FEF75 were measured and information on physician-diagnosed asthma was obtained by a questionnaire. Regression models were accounted for socioeconomic, lifestyle and growth factors, and early life wheezing.

Results: Upper respiratory tract infections were not associated with lower lung function or risk of asthma. Lower respiratory tract infections ≤3 years were associated with lower FEV1, FVC and FEV1/FVC (Z score (95% CI): -0.22 (-0.32, -0.12), -0.14 (-0.23, -0.04) and -0.11 (-0.21, -0.02)), and a higher risk of asthma (OR (95% CI): 3.42 (2.26, 5.16)), compared with no lower respiratory tract infections. Lower respiratory tract infections >3 years were associated with a higher risk of asthma (2.55 (1.60, 4.07)) only. Cross-lagged modeling showed that the associations were not in the opposite direction.

Conclusions: Early-life lower respiratory tract infections are most consistently associated with lower lung function and increased risk of asthma in school-aged children, while upper respiratory tract infections are not.

  • Epidemiology
  • Longitudinal study
  • Copyright ©the authors 2016
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Early-life respiratory tract infections and risk of lower lung function and asthma at school-age. The generation R study
Evelien van Meel, Herman T. den Dekker, Niels J. Elbert, Henriëtte A. Moll, Irwin K. Reiss, Johan C. de Jongste, Vincent W.V. Jaddoe, Liesbeth Duijts
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3134; DOI: 10.1183/13993003.congress-2016.PA3134

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Early-life respiratory tract infections and risk of lower lung function and asthma at school-age. The generation R study
Evelien van Meel, Herman T. den Dekker, Niels J. Elbert, Henriëtte A. Moll, Irwin K. Reiss, Johan C. de Jongste, Vincent W.V. Jaddoe, Liesbeth Duijts
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3134; DOI: 10.1183/13993003.congress-2016.PA3134
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