Brigham and Women's Hospital, Boston, MA, USA.
Stanford School of Medicine, Stanford, CA, USA.
Respir Med. 2023 Nov;218:107401. doi: 10.1016/j.rmed.2023.107401. Epub 2023 Aug 30.
Understanding early life risk factors for decreased lung function could guide prevention efforts and improve lung health throughout the lifespan. Our objective was to investigate the association between history of severe (hospitalized) bronchiolitis in infancy and age 6-year lung function.
We analyzed data from two prospective cohort studies: infants hospitalized with bronchiolitis and a parallel cohort of healthy infants. Children were followed longitudinally, and spirometry was performed at age 6 years. To examine the relationship between history of severe bronchiolitis and primary outcomes - FEV1% predicted (pp) and FEV1/FVCpp - we used multivariable linear regression models adjusted for insurance status, perterm birth, secondhand smoke exposure, breastfeeding status, traffic-related air pollution and polygenic risk score. Secondary outcomes included FVCpp and bronchodilator responsiveness (BDR).
Age 6-year spirometry was available for 425 children with history of severe bronchiolitis in infancy and 48 controls. Unadjusted analysis revealed that while most children had normal range lung function, children with a history of severe bronchiolitis had lower FEV1pp and FEV1/FVCpp. In adjusted analyses, the same findings were observed: FEV1pp was 8% lower (p = 0.004) and FEV1/FVCpp was 4% lower (p = 0.007) in children with history of severe bronchiolitis versus controls. FVC and BDR did not differ between groups.
Children with severe bronchiolitis in infancy have decreased FEV1 and FEV1/FVC at age 6 years, compared to controls. These children may be at increased risk for chronic respiratory illness later in life.
了解生命早期肺功能下降的风险因素有助于指导预防工作，并改善整个生命周期的肺部健康。我们的目的是研究婴儿期严重（住院）毛细支气管炎病史与 6 岁时肺功能的关系。
我们分析了两项前瞻性队列研究的数据：住院毛细支气管炎婴儿和健康婴儿的平行队列。对儿童进行纵向随访，并在 6 岁时进行肺活量测定。为了研究严重毛细支气管炎病史与主要结局（FEV1%预测值[pp]和 FEV1/FVCpp）之间的关系，我们使用了多变量线性回归模型，调整了保险状况、早产儿、二手烟暴露、母乳喂养状况、交通相关空气污染和多基因风险评分。次要结局包括 FVCpp 和支气管扩张剂反应性（BDR）。
425 例有严重毛细支气管炎病史的婴儿和 48 名对照者的 6 岁时肺活量测定结果可供分析。未调整分析显示，虽然大多数儿童的肺功能处于正常范围，但有严重毛细支气管炎病史的儿童的 FEV1pp 和 FEV1/FVCpp 较低。在调整分析中，观察到同样的结果：与对照组相比，有严重毛细支气管炎病史的儿童的 FEV1pp 低 8%（p=0.004），FEV1/FVCpp 低 4%（p=0.007）。FVC 和 BDR 在两组之间无差异。
与对照组相比，患有严重毛细支气管炎的婴儿在 6 岁时的 FEV1 和 FEV1/FVC 较低。这些儿童以后可能有患慢性呼吸道疾病的风险增加。
