Lower respiratory tract infections in early life are associated with obstructive sleep apnea diagnosis during childhood in a large birth cohort

SLEEP ◽  
2021 ◽  
Author(s):  
Maria J Gutierrez ◽  
Gustavo Nino ◽  
Jeremy S Landeo-Gutierrez ◽  
Miriam R Weiss ◽  
Diego A Preciado ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Respiratory Tract ◽  
Birth Cohort ◽  
Early Life ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Lower Respiratory Tract Infections ◽  
Obstructive Sleep ◽  
Tract Infections

Abstract Study Objectives Several birth cohorts have defined the pivotal role of early lower respiratory tract infections (LRTI) in the inception of pediatric respiratory conditions. However, the association between early LRTI and the development of obstructive sleep apnea (OSA) in children has not been established. Methods To investigate whether early LRTIs increase the risk of pediatric OSA, we analyzed clinical data in children followed during the first 5 years in the Boston Birth Cohort (n = 3114). Kaplan–Meier survival estimates and Cox proportional hazards models adjusted by pertinent covariates were used to evaluate the risk of OSA by the age of 5 years between children with LRTI during the first 2 years of life in comparison to those without LRTI during this period. Results Early life LRTI increased the risk of pediatric OSA independently of other pertinent covariates and risk factors (hazard ratio, 1.53; 95% CI, 1.15 to 2.05). Importantly, the association between LRTI and pediatric OSA was limited to LRTIs occurring during the first 2 years of life. Complementarily to this finding, we observed that children who had severe respiratory syncytial virus bronchiolitis during infancy had two times higher odds of OSA at 5 years in comparison with children without this exposure (odds ratio, 2.09; 95% CI, 1.12 to 3.88). Conclusions Children with severe LRTIs in early life have significantly increased risk of developing OSA during the first 5 years of life. Our results offer a new paradigm for investigating novel mechanisms and interventions targeting the early pathogenesis of OSA in the pediatric population.

scholarly journals Lung function at school age in infants with lower respiratory tract infections with and without wheezing: a birth cohort study.

2021 ◽  
Author(s):  
Franca Rusconi ◽  
Enrico Lombardi ◽  
Elena Spada ◽  
Sonia Brescianini ◽  
Martina Culasso ◽  
...  
Keyword(s):  
Lung Function ◽  
Respiratory Tract ◽  
Birth Cohort ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Birth Cohort Study ◽  
School Age ◽  
Z Score ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Objective: To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy). Methods: Data on LRTI (doctor diagnosis of bronchitis, bronchiolitis, pneumonia) and wheezing (≥3 episodes or a diagnosis of asthmatic bronchitis) in the first 2 years of life were obtained from parental questionnaires. Lung function was assessed at 7 years by spirometry and forced volume vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow between 25 and 75%, and at 75% of FVC (FEF25-75 and FEF75) were reported as z-scores. The associations between LRTI and spirometric variables were estimated with linear regression models. Results: Among 877 children studied, 22.1% had LRTI only, 5.4% wheezing only, 13.2% had both, and 59.3% had neither LRTI nor wheezing. Children with LRTI had lower FVC and FEV1 than children without (z-score differences: -0.18 (95% Confidence Intervals, -0.31; -0.06) and -0.15 ( 0.27; -0.03)). When children were stratified by history of both LRTI and wheezing, there was no association between LRTI only and spirometric values. Conversely, having had both LRTI and wheezing was inversely associated with all lung function measures: z-score differences of -0.24 ( 0.42; -0.07); -0.42 (-0.59; -0.24); -0.25 (-0.41; -0.08); -0.37 (-0.54; -0.21); -0.30 (-0.46; -0.14) for FVC, FEV1, FEV1/FVC, FEF25-75 and FEF75, respectively. Conclusion: Infants with wheezing and LRTI, but not those with LRTI only, had reduced lung function at school-age.

Lower Respiratory Tract Infections in Children in a Well-vaccinated South African Birth Cohort: Spectrum of Disease and Risk Factors

2019 ◽  
Vol 69 (9) ◽  
pp. 1588-1596 ◽  
Author(s):  
David M le Roux ◽  
Mark P Nicol ◽  
Landon Myer ◽  
Aneesa Vanker ◽  
Jacob A M Stadler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Tract ◽  
Birth Cohort ◽  
Maternal Smoking ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
World Health ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
Substantial Morbidity

Abstract Background Childhood lower respiratory tract infections (LRTIs) cause substantial morbidity and under-5 child mortality. The epidemiology of LRTI is changing in low- and middle-income countries with expanding access to conjugate vaccines, yet there are few data on the incidence and risk factors for LRTI in these settings. Methods A prospective birth cohort enrolled mother–infant pairs in 2 communities near Cape Town, South Africa. Active surveillance for LRTI was performed for the first 2 years of life over 4 respiratory seasons. Comprehensive data collection of risk factors was done through 2 years of life. World Health Organization definitions were used to classify clinical LRTI and chest radiographs. Results From March 2012 to February 2017, 1143 children were enrolled and followed until 2 years of age. Thirty-two percent of children were exposed to antenatal maternal smoking; 15% were born at low birth weights. Seven hundred ninety-five LRTI events occurred in 429 children by February 2017; incidence of LRTI was 0.51 and 0.25 episodes per child-year in the first and second years of life, respectively. Human immunodeficiency virus (HIV)–exposed, uninfected infants (vs HIV-unexposed infants) were at increased risk of hospitalized LRTI in the first 6 months of life. In regression models, male sex, low birth weight, and maternal smoking were independent risk factors for both ambulatory and hospitalized LRTI; delayed or incomplete vaccination was associated with hospitalized LRTI. Conclusions LRTI incidence was high in the first year of life, with substantial morbidity. Strategies to ameliorate harmful exposures are needed to reduce LRTI burden in vulnerable populations.

scholarly journals A population-based prospective cohort study examining the influence of early-life respiratory tract infections on school-age lung function and asthma

Thorax ◽  
2017 ◽  
Vol 73 (2) ◽  
pp. 167-173 ◽  
Author(s):  
Evelien R van Meel ◽  
Herman T den Dekker ◽  
Niels J Elbert ◽  
Pauline W Jansen ◽  
Henriëtte A Moll ◽  
...  
Keyword(s):  
Lung Function ◽  
Respiratory Tract ◽  
Early Life ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Population Based ◽  
Lower Respiratory Tract Infections ◽  
School Aged Children ◽  
Increased Risk ◽  
Tract Infections

BackgroundEarly-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent.ObjectiveWe examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children.MethodsThis study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤ 3 and >3–6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years.ResultsUpper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV1, FVC, FEV1:FVC and forced expiratory flow at 75% of FVC (FEF75) (Z-score (95% CI): ranging from −0.22 (−0.31 to –0.12) to −0.12 (−0.21 to −0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3–6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns.ConclusionEarly-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children.

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