Published ahead of print on June 1, 2004, doi:10.1164/rccm.200311-1583OC
American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 534-540, (2004)
© 2004 American Thoracic Society
doi: 10.1164/rccm.200311-1583OC
Small Size at Birth and Greater Postnatal Weight Gain
Relationships to Diminished Infant Lung Function
Jane S. Lucas,
Hazel M. Inskip,
Keith M. Godfrey,
Claire T. Foreman,
John O. Warner,
Rachael K. Gregson and
Joanne B. Clough
Allergy and Inflammation Sciences Division, University of Southampton, Southampton General Hospital; and MRC Environmental Epidemiology Unit, University of Southampton, Southampton, United Kingdom
Correspondence and requests for reprints should be addressed to Keith M. Godfrey, B.M., Ph.D., MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK. E-mail: kmg{at}mrc.soton.ac.uk
Recent evidence suggests that impaired lung development is linked with diminished lung function and an increased risk of chronic obstructive airway disease in adulthood. To examine environmental influences on early lung development, we measured lung function in 131 normal-term infants aged 5–14 weeks. Adjusting for age at measurement, FEV at 0.4 seconds fell by 4.4% for each standard deviation decrease in birth weight (p = 0.047); when adjusted for FVC, FEV at 0.4 seconds was not related to birth weight but fell by 3.2% per standard deviation increase in infant weight gain (p = 0.001). Age- and sex-adjusted total respiratory system compliance fell by 7.0% per standard deviation decrease in birth weight (p < 0.001) but was not related to infant weight gain. In univariate analyses, age-adjusted forced expiratory flow at functional residual capacity was not related to birth weight, but decreased by 11.0% per standard deviation increase in infant weight gain (p = 0.007). The respiratory rate rose by 5.1% per standard deviation increase in infant weight gain (p = 0.001). Lung function measurements were not related to infant feeding. The observations suggest that lower rates of fetal growth and higher rates of early infancy weight gain are associated with impaired lung development.
Key Words: infant • FEV • forced expiratory flow rates • lung function • weight gain
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