Infants with flow limitation at 4 weeks: Outcome at 6 and 11 years

Stephen William Turner, L. L. Palmer, P. J. Rye, N. A. Gibson, P. K. Judge, S. Young, L. I. Landau, P. N. Le Souef

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Abstract

Within a longitudinal study of lung function in 243 infants, we identified a group of 23 individuals with flow limitation in tidal expiration. In infancy, flow-limited children have reduced lung function and increased airway responsiveness (AR), and at 2 years of age they are diagnosed with asthma more frequently. We hypothesized that these observations would persist throughout childhood. Data from ages 3 to 11 years were analyzed. Only at 4 years of age did the flow-limited group have increased wheeze compared with other cohort members (odds ratio, 4.25; 95% confidence interval [CI], 1.11 to 16.2; p = 0.04; n = 114). At 6 years of age, 117 cohort members were seen. The flow-limited group (n = 14) had greater AR (p = 0.009) and reduced mean FEV1 (131 ml; 95% CI, 16 to 246; p = 0.03) and FEF25-75 (0.28 L/second; 95% CI, 0.05 to 0.52; p = 0.02). At 11 years of age, 183 children were seen and the flow-limited group (n = 18) had greater AR (p = 0.02) and a trend toward reduced mean FEF25-75 (0.24 L/second; 95% CI, -0.02 to 0.49; p = 0.08). Atopy and parental asthma were not increased in the flow-limited group. We suggest that the physiologic abnormality that causes flow limitation in early infancy may identify an at-risk group, different from asthma, who have reduced lung function and increased airway responsiveness in later life.

Original languageEnglish
Pages (from-to)1294-1298
Number of pages4
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume165
Issue number9
DOIs
Publication statusPublished - May 2002

Keywords

  • bronchial hyperreactivity
  • child
  • longitudinal studies
  • respiratory function tests
  • AIRWAY RESPONSIVENESS
  • LUNG-FUNCTION
  • BRONCHIAL RESPONSIVENESS
  • PULMONARY-FUNCTION
  • CHILDHOOD ASTHMA
  • RISK FACTOR
  • LIFE
  • METHACHOLINE
  • CHILDREN
  • HYPERRESPONSIVENESS

Cite this

Turner, S. W., Palmer, L. L., Rye, P. J., Gibson, N. A., Judge, P. K., Young, S., Landau, L. I., & Le Souef, P. N. (2002). Infants with flow limitation at 4 weeks: Outcome at 6 and 11 years. American Journal of Respiratory and Critical Care Medicine, 165(9), 1294-1298. https://doi.org/10.1164/rccm.200110-018OC