Lung Function, Allergic Sensitization and Asthma in School-Aged Children After Viral-Coinfection Bronchiolitis

Abstract BACKGROUND. Our main objective was to compare the lung function, the rate of allergic sensitization and the prevalence of asthma at 7-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection.METHODS. Observational study in children with previous bronchiolitis and current age 7-9 years. Clinical data were collected. Fraction of exhaled nitric oxide (FeNO) determination, spirometry and skin prick test for common aeroallergens were performed.RESULTS. A total of 181 children hospitalized for bronchiolitis (40 coinfections and 141 single infections), with median age of 8.3 years (IQR:7.5-9.1) were included. Single-HRV-infections showed lower basal FEV1(%) than coinfections (p=0.04) and lower z-score FEV1 than single-RSV-infections(p=0.04) or coinfections(p=0.02). Also, single-HRV-infections had lower post-bronchodilator FEV1(%) and z-score FEV1 values than coinfections (p=0.03 and p=0.03). Single-HRV-bronchiolitis was an independent risk factor for FEV1<80%(p=0.007). FeNO value >25 ppb was detected in 21(12.5%) cases, without differences between viral groups(p=0.768). The prevalence of allergic sensitization was similar in coinfections (31.4%) versus single infections (38.7%), (p=0.428). The highest frequency of allergic rhinitis was observed in single-HRV patients(p=0.004).The respiratory morbidity at 7-9 years of coinfected patients was similar to the single-HRV ones. In contrast, the likelihood of current asthma was up to 5 times higher in RSV/HRV coinfections than in the single-RSV-infections ones (p=0.012).CONCLUSIONS. The respiratory morbidity at 7-9 years of age after severe bronchiolitis is significantly higher in single-HRV or viral coinfection patients that in single-RSV ones. Single-HRV-bronchiolitis is independently associated with lower lung function at school-age.

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Role Of Viral Coinfections In Asthma Development In Children With Severe Bronchiolitis In Early Childhood

10.21203/rs.3.rs-41985/v1 ◽

2020 ◽

Author(s):

Sara Ruiz ◽

Cristina Calvo ◽

Francisco Pozo ◽

Inmaculada Casas ◽

María Luz García-García

Keyword(s):

Lung Function ◽

Allergic Sensitization ◽

Epidemiological Data ◽

Single Infection ◽

Medical Visit ◽

Recurrent Wheezing ◽

Current Asthma ◽

Prick Test ◽

Sensitization Rate ◽

Viral Coinfection

Abstract BACKGROUND. Severe viral bronchiolitis is associated with a higher risk of developing asthma, but little is known about the medium-term prognosis and the lung function evolution of patients admitted for viral coinfection-associated bronchiolitis. Our main objective was to compare the lung function, the prevalence of asthma and the rate of allergic sensitization at 6-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection.METHODS. Observational, longitudinal study in children previously hospitalized for viral bronchiolitis with current age between 6-9 years. Clinical and epidemiological data were collected. Fraction of exhaled nitric oxide determination, spirometry and skin prick test for common aeroallergens were performed.RESULTS. A total of 244 bronchiolitis-admitted children (52 coinfections and 192 single infections), with current age 6-9 years, accepted to participate by telephone answering the clinical questionnaires. Of them, 181 patients agreed for a medical visit. The overall frequency of asthma was 21%, being this prevalence almost twice as high in the viral coinfection group (p = 0.049). The coinfection cohort had more than twice as many admissions (p = 0.04), was more likely to receive montelukast (p = 0.06) and salmeterol/fluticasone treatment (p = 0.03) than the single-infection one. No differences regarding lung function values or allergic sensitization rate were observed between both groups.The variables independently related to current asthma at 6-9 years were: viral coinfection during bronchiolitis (p = 0.004), allergic rhinitis (p = 0.001), food allergy (p = 0.05) and atopic dermatitis (p = 0.017). CONCLUSIONS. Severe bronchiolitis associated with double or multiple viral detection in the first 24 months is an independent risk factor for higher frequency and greater severity of asthma at 6-9 years, being this risk almost three times higher compared to single infection. This fact is suggested by the higher frequency of current asthma, symptoms in intercrisis periods, maintenance anti-asthma treatment and number of hospitalizations for recurrent wheezing in children with coinfection compared to single infection. Early viral etiology identification in severe bronchiolitis might facilitate the prompt prediction and treatment of asthma in school age.

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Parental psychological distress during pregnancy and the risk of childhood lower lung function and asthma: a population-based prospective cohort study

Thorax ◽

10.1136/thoraxjnl-2019-214099 ◽

2020 ◽

Vol 75 (12) ◽

pp. 1074-1081

Author(s):

Evelien R van Meel ◽

Gautam Saharan ◽

Vincent WV Jaddoe ◽

Johan C de Jongste ◽

Irwin KM Reiss ◽

...

Keyword(s):

Psychological Distress ◽

Lung Function ◽

Prospective Cohort ◽

Later Life ◽

Population Based ◽

Brief Symptom Inventory ◽

Respiratory Morbidity ◽

Maternal Psychological Distress ◽

Increased Risk ◽

Lower Lung

BackgroundAlthough maternal psychological distress during pregnancy is associated with increased risks of respiratory morbidity in preschool children, it is unknown whether this association persists into later childhood.ObjectiveTo examine the association between parental psychological distress during pregnancy and lung function and asthma in children of school age.MethodsThis study of 4231 children was embedded in a population-based prospective cohort. Parental psychological distress was assessed by the Brief Symptom Inventory during and 3 years after pregnancy, and in mothers also at 2 and 6 months after pregnancy. At age 10 years, lung function was obtained by spirometry and asthma by questionnaire.ResultsThe prevalence of asthma was 5.9%. Maternal overall psychological distress during pregnancy was associated with a lower forced vital capacity (FVC) (z-score difference −0.10 (95% CI −0.20 to –0.01) per 1-unit increase), maternal depressive symptoms during pregnancy with a lower forced expiratory volume in the first second (FEV1) and FVC (−0.13 (95% CI −0.24 to –0.01) and −0.13 (95% CI −0.24 to –0.02) when using clinical cut-offs) in their children. All maternal psychological distress measures during pregnancy were associated with an increased risk of asthma (range OR: 1.46 (95% CI 1.12 to 1.90) to 1.91 (95% CI 1.26 to 2.91)). Additional adjustment for paternal psychological distress during pregnancy and parental psychological distress after pregnancy did not materially change the associations. Paternal psychological distress during pregnancy was not associated with childhood respiratory morbidity.ConclusionMaternal, but not paternal, psychological distress during pregnancy is associated with an increased risk of asthma and partly lower lung function in children. This suggests intrauterine programming for the risk of later-life respiratory disease.

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

10.22541/au.163667937.76022399/v1 ◽

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.

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Early-life respiratory tract infections and risk of lower lung function and asthma at school-age. The generation R study

10.1183/13993003.congress-2016.pa3134 ◽

2016 ◽

Author(s):

Evelien van Meel ◽

Herman T. den Dekker ◽

Niels J. Elbert ◽

Henriëtte A. Moll ◽

Irwin K. Reiss ◽

...

Keyword(s):

Lung Function ◽

Respiratory Tract ◽

Early Life ◽

Respiratory Tract Infections ◽

School Age ◽

Lower Lung ◽

Tract Infections

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Maternal blood pressure and hypertensive disorders during pregnancy and childhood respiratory morbidity: the Generation R Study

European Respiratory Journal ◽

10.1183/13993003.00378-2018 ◽

2018 ◽

Vol 52 (5) ◽

pp. 1800378 ◽

Cited By ~ 5

Author(s):

Freke A. Wilmink ◽

Herman T. den Dekker ◽

Johan C. de Jongste ◽

Irwin K.M. Reiss ◽

Vincent W.V. Jaddoe ◽

...

Keyword(s):

Blood Pressure ◽

Lung Function ◽

Maternal Blood ◽

Respiratory Morbidity ◽

Current Asthma ◽

Hypertensive Disorders ◽

Increased Risk ◽

Lower Lung ◽

Asthma In Children ◽

Maternal Blood Pressure

Pre-eclampsia is associated with an increased risk of bronchopulmonary dysplasia, wheezing and asthma in later childhood. Currently, there are no studies available investigating maternal blood pressure measurements during multiple time-points in pregnancy and respiratory outcome measures in the child.We examined the associations of maternal blood pressure and hypertensive disorders with the risk of lower lung function, wheezing and asthma in children aged 10 years. This study among 4894 children was embedded in a population-based prospective cohort study. We used multivariate analyses, taking lifestyle and socioeconomic factors into account.We observed consistent associations per 5 mmHg higher maternal blood pressure in early pregnancy with a lower forced expiratory volume in 1 s/forced vital capacity ratio (z-score −0.03 (95% CI −0.05– −0.01)) and per 5 mmHg higher blood pressure in late pregnancy with a higher risk for current wheezing and current asthma (OR 1.07 (95% CI 1.02–1.12) and 1.06 (95% CI 1.00–1.11), respectively). We found no associations of maternal hypertensive disorders during pregnancy with child lung function, current wheezing or current asthma.Our results suggest that higher blood pressure in pregnant women is associated with lower lung function and increased risks of current wheezing and current asthma in children. The associations may be trimester specific.

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Impact of Preterm Birth and Post-Discharge Growth on Cardiometabolic Outcomes at School Age: A Case Control Study

10.21203/rs.3.rs-124744/v1 ◽

2020 ◽

Author(s):

Jungha Yun ◽

Young Hwa Jung ◽

Seung Han Shin ◽

In Gyu Song ◽

Young Ah Lee ◽

...

Keyword(s):

Preterm Birth ◽

Fat Mass ◽

Case Control Study ◽

Fasting Glucose ◽

Case Control ◽

School Age ◽

Z Score ◽

School Aged Children ◽

Early School ◽

Control Study

Abstract Background: Adverse metabolic outcomes later in life have been reported among children or young adults who were born small for gestational age. This study was conducted to examine the impact of preterm birth and subsequent growth after hospital discharge on cardiometabolic risks among early school-aged children. Methods: This case-control study included school-aged children born prematurely (n = 60) and at term (n = 110). Body size, fat mass, blood pressure (BP), glucose, insulin, leptin, adiponectin, and lipid profiles were measured. Weight z-score changes between discharge and early school-age period were also calculated, and factors associated with BP and insulin resistance were analyzed.Results: Early school-aged children who were born preterm had lower fat masses, higher systolic BP and diastolic BP, and higher values of fasting glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR), compared to children born at term. Preterm birth was correlated with HOMA-IR and BPs after adjusting for various factors, including fat mass index and weight z-score changes. Weight z-score changes were associated with HOMA-IR, but not with BPs. Conclusions: Although early school-aged children born prematurely showed lower weight and fat mass, they had higher BPs, fasting glucose, HOMA-IR, and leptin levels. The associations of preterm birth with cardiometabolic factors were independent of weight, fat mass and weight gain velocity.

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Traffic-related air pollution exposure over a 5-year period is associated with increased risk of asthma and poor lung function in middle age

European Respiratory Journal ◽

10.1183/13993003.02357-2016 ◽

2017 ◽

Vol 50 (4) ◽

pp. 1602357 ◽

Cited By ~ 33

Author(s):

Gayan Bowatte ◽

Bircan Erbas ◽

Caroline J. Lodge ◽

Luke D. Knibbs ◽

Lyle C. Gurrin ◽

...

Keyword(s):

Air Pollution ◽

Lung Function ◽

Current Evidence ◽

Respiratory Morbidity ◽

Asthma Prevalence ◽

Major Road ◽

Current Asthma ◽

Increased Risk ◽

Lower Lung ◽

The Impact

Current evidence concerning the impact of exposure to traffic-related air pollution (TRAP) on adult respiratory morbidity mainly comes from cross-sectional studies. We sought to establish more robust measures of this association and potential gene–environment interactions using longitudinal data from an established cohort study.Associations between measures of TRAP (nitrogen dioxide (NO2) and distance to major roads) and wheeze, asthma prevalence and lung function were investigated in participants of the Tasmanian Longitudinal Health Study at 45- and 50-year follow-ups. Generalised estimating equations were used to quantify associations and the potential modifying effect of glutathioneS-transferase gene variants.Living <200 m from a major road was associated with increased prevalence of current asthma and wheeze, and lower lung function. The association between living <200 m from a major road and current asthma and wheeze was more marked for carriers of theGSTT1null andGSTP1 val/valorile/valgenotypes. Over the 5-year period, higher NO2exposures were associated with increased current asthma prevalence. Higher NO2exposure was associated with lower forced vital capacity for carriers of theGSTT1null genotype.TRAP exposures were associated with increased risk of asthma, wheeze and lower lung function in middle-aged adults. The interaction with theGSTT1genotype suggests that deficient antioxidant mechanisms may play a role in these adverse health effects.

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Intrauterine growth restriction predicts lower lung function at school age in children born very preterm

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2015-308922 ◽

2016 ◽

Vol 101 (5) ◽

pp. F412-F417 ◽

Cited By ~ 26

Author(s):

Eveliina Ronkainen ◽

Teija Dunder ◽

Tuula Kaukola ◽

Riitta Marttila ◽

Mikko Hallman

Keyword(s):

Lung Function ◽

Intrauterine Growth Restriction ◽

Growth Restriction ◽

School Age ◽

Intrauterine Growth ◽

Very Preterm ◽

Lower Lung

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Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children

Scientific Reports ◽

10.1038/s41598-021-86292-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yoo Jinie Kim ◽

Seung Han Shin ◽

Eun Sun Lee ◽

Young Hwa Jung ◽

Young Ah Lee ◽

...

Keyword(s):

Birth Weight ◽

Preterm Infants ◽

Gestational Age ◽

Growth Velocity ◽

Postnatal Growth ◽

School Age ◽

Z Score ◽

Neurodevelopmental Outcomes ◽

Neurocognitive Outcomes ◽

Size At Birth

AbstractPrematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.

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