Effect on Symptoms, Sensitization, and Lung Function at Age 3 Years
Ashley Woodcock,
Lesley A. Lowe,
Clare S. Murray,
Bridget M. Simpson,
Spyros D. Pipis,
Patricia Kissen,
Angela Simpson and
Adnan Custovic on behalf of the NAC Manchester Asthma and Allergy Study Group
North West Lung Centre, Wythenshawe Hospital, Manchester, United Kingdom
Correspondence and requests for reprints should be made to Adnan Custovic, M.D., Ph.D., North West Lung Centre, Wythenshawe Hospital, Manchester M23 9LT, UK. E-mail: a.custovic{at}man.ac.uk
We investigated whether environmental control during pregnancyand early life affects sensitization and lung function at theage of 3 years. High-risk children (n = 251) were prenatallyrandomized to stringent environmental control (active) or nointervention (control). Questionnaires, skin testing, IgE, andspecific airway resistance (sRaw) measurement were completedat the age of 3 years. Children in the active group were significantlymore frequently sensitized compared with control subjects (atleast one allergen by skin tests: risk ratio, 1.61; 95% confidenceinterval [CI], 1.02–2.55; p = 0.04; mite by IgE: riskratio, 2.85; 95% CI, 1.02–7.97; p = 0.05). However, sRawwas significantly better in the active group (kiloPascal/second,geometric mean [95% CI]: 1.05 [1.01–1.10] vs. 1.19 [1.13–1.25],p < 0.0001, active vs. control). Maximal flow at functionalresidual capacity was measured using rapid thoracic compressionat the age of 4 weeks in a subgroup. Prospective lung functiondata (at infancy and 3 years) were obtained in 32 children (14active and 18 control). There was no difference in infant lungfunction between the groups, but at 3 years, sRaw was significantlylower in the active compared with control children (p = 0.003).Stringent environmental control was associated with increasedrisk of mite sensitization but better results for some measurementsof lung function in high-risk children at the age of 3 years.
Key Words: asthma • atopy • environmental control • lung function • primary prevention
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