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Published ahead of print on February 5, 2004, doi:10.1164/rccm.200307-891OC

Am. J. Respir. Crit. Care Med., Volume 169, Number 8, April 2004, 921-927

A more recent version of this article appeared on April 15, 2004
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Submitted on August 14, 2003
Accepted on January 25, 2004

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

Stephen W Turner1*, Lyle J Palmer1, Peter J Rye1, Neil A Gibson1, Parveenjeet K Judge1, Moreen Cox1, Sally Young1, Jack Goldblatt1, Louis I Landau1, and Peter N Le Souef1

1 School of Paediatrics and Child Health and Department of Respiratory Medicine, University of Western Australia, Perth, WA, Australia

* To whom correspondence should be addressed. E-mail: s.w.turner{at}abdn.ac.uk.

The relationship between reduced pulmonary function in early life and persistent wheeze in school-aged children remains uncertain. In this study, maximal flow at functional residual capacity (V'maxFRC) was assessed at one month of age and the presence of wheeze up to eleven years of age was prospectively identified. At eleven years of age, airway responsiveness to inhaled histamine (AR) and atopy were assessed. Recent wheeze at eleven years of age was associated with reduced mean z score for V'maxFRC at one 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 four and six years which persisted at eleven years (PW) was most prevalent among those with reduced V'maxFRC at one month and atopy aged eleven years (p=0.002) or reduced V'maxFRC and increased AR aged eleven years (p=0.015). When all factors were considered, reduced V'maxFRC at one month (p=0.03) and increased AR aged eleven 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 persistent wheeze at eleven years of age and this relationship is independent of the effect of increased AR and atopy in childhood.
Key words: asthma; respiratory sounds; respiratory function tests; longitudinal study; infant; child




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