The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Dept of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Eur Respir J. 2022 Oct 6;60(4). doi: 10.1183/13993003.02395-2021. Print 2022 Oct.
Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.
We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), FEV/FVC, forced expiratory flow at 75% of FVC (FEF) and asthma at a median (range) age of 7 (4-15) years.
Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV, FEV/FVC and FEF (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.
Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.
儿童早期呼吸道感染可能会影响慢性阻塞性呼吸道疾病，但缺乏来自普通人群的明确研究。我们的目的是研究儿童早期呼吸道感染是否会增加其在学龄期时肺部功能下降和哮喘的风险。
我们使用来自欧盟儿童队列网络的 150090 名儿童的个体参与者数据，研究了从 6 个月到 5 岁时的上呼吸道和下呼吸道感染与第 1 秒用力呼气量（FEV）、用力肺活量（FVC）、FEV/FVC、75%用力肺活量时的呼气流量（FEF）以及中位数（范围）年龄在 7 岁（4-15 岁）时的哮喘之间的关联。
患有儿童早期下呼吸道感染的儿童在校年龄的 FEV、FEV/FVC 和 FEF 较低（z 分数范围：-0.09（95%CI-0.14 至-0.04）至-0.30（95%CI-0.36 至-0.24））。与上呼吸道感染相比，患有儿童早期下呼吸道感染的儿童在校年龄时哮喘的风险更高（比值比范围：2.10（95%CI 1.98-2.22）至 6.30（95%CI 5.64-7.04）和 1.25（95%CI 1.18-1.32）至 1.55（95%CI 1.47-1.65））。调整先前的呼吸道感染后，这些影响的强度略有降低。对于使用儿童早期喘息作为儿童早期哮喘的替代指标，观察到的关联在有和没有儿童早期喘息的人群中相似。
我们的研究结果表明，儿童早期呼吸道感染会影响其日后慢性阻塞性呼吸道疾病的发展，而下呼吸道感染的影响最强。
