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The Relationship between Infant Airway Function, Childhood Airway Responsiveness, and Asthma

School of Paediatrics and Child Health, University of Western Australia, and Department of Respiratory Medicine, Princess Margaret Hospital for Children, Perth, Australia

Correspondence and requests for reprints should be addressed to Stephen W. Turner, M.D., School of Medicine, Department of Child Health, Aberdeen Children's Hospital, Foresterhill, Aberdeen AB25 2ZG, Scotland. E-mail: s.w.turner{at}abdn.ac.uk

The relationship between reduced pulmonary function in early life and persistent wheeze (PW) in school-aged children remains uncertain. In this study, maxFRC was assessed at 1 month of age, and the presence of wheeze up to 11 years of age was prospectively identified. At 11 years of age, airway responsiveness (AR) to inhaled histamine and atopy were assessed. Recent wheeze at 11 years of age was associated with a reduced mean z score for maxFRC at 1 month of age (–0.41 [SD 0.91], n = 31) compared with no recent wheeze (0.04 [SD 1.00], n = 153, p = 0.03). Wheeze between 4 and 6 years that persisted at 11 years (PW) was most prevalent among those with reduced maxFRC at 1 month and atopy aged 11 years (p = 0.002) or reduced maxFRC and increased AR aged 11 years (p = 0.015). When all factors were considered, reduced maxFRC at 1 month (p = 0.03) and increased AR aged 11 years (p < 0.001) were independently associated with PW (n = 17) compared with other outcomes (n = 129). Reduced airway function present in early infancy is associated with PW at 11 years of age, and this relationship is independent of the effect of increased AR and atopy in childhood.

Key Words: respiratory sounds • respiratory function tests • longitudinal study • infant

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