Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals

David Mullane; Stephen William Turner; Des W Cox; Jack Goldblatt; Lou I Landau; Peter N le Souëf

doi:10.1001/jamapediatrics.2013.633

Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals

David Mullane, Stephen William Turner, Des W Cox, Jack Goldblatt, Lou I Landau, Peter N le Souëf

University of Western Australia

Research output: Contribution to journal › Article › peer-review

33 Citations (Scopus)

Abstract

IMPORTANCE This is the first study to link reduced lung function in early life, before the development of symptoms, to wheeze in 18-year-olds. Additionally, the study gives insight into factors other than reduced lung function that are also associated with persistent wheeze in young adults.

OBJECTIVE: To test the hypothesis that reduced lung function in early life is associated with increased risk for persistent wheeze at age 18 years.

DESIGN: Birth cohort study.

SETTING: Perth, Western Australia.

PARTICIPANTS: Individuals followed up from age 1 month to 18 years.

MAIN OUTCOME MEASURES: Maximal flow at functional residual capacity (V'maxFRC) was measured in 1-month-old infants who were followed up at ages 6, 12, and 18 years. Based on reported symptoms, individuals were categorized as having remittent wheeze, later-onset wheeze, persistent wheeze, and no wheeze. Smoking status was noted at age 18 years.

RESULTS: Of the 253 individuals originally recruited, 150 were followed up at age 18 years; 37 of the 150 had recent wheeze. Compared with the no-wheeze group (n = 96), persistent wheeze (n = 13) was independently associated with reduced percentage of predicted V'maxFRC (mean reduction, 43%; 95% CI, 13-74). Compared with the no-wheeze group, persistent wheeze was also associated with atopy in infancy (odds ratio = 7.1; 95% CI, 1.5-34.5), maternal asthma (odds ratio = 6.8; 95% CI, 1.4-32.3), and active smoking (odds ratio = 4.8; 95% CI, 1.0-21.3). When only wheeze at age 18 years was considered, reduced percentage of predicted V'maxFRC was associated with wheeze at age 18 years only among current smokers (P = .04).

CONCLUSIONS AND RELEVANCE: Wheeze persisting from ages 6 to 18 years is associated with multiple factors, including reduced infant lung function, infant-onset atopy, maternal asthma, and active smoking. Wheeze at age 18 years (regardless of previous wheeze status) is associated with active smoking, but only among those with reduced lung function in infancy. These findings give unique insight into the cause of obstructive airways disease in 18-year-olds, and follow-up of this cohort might be expected to further extend our understanding.

Original language	English
Pages (from-to)	368-73
Number of pages	6
Journal	JAMA pediatrics
Volume	167
Issue number	4
Early online date	18 Feb 2013
DOIs	https://doi.org/10.1001/jamapediatrics.2013.633
Publication status	Published - Apr 2013

Bibliographical note

Funding/Support: This work was supported by the National Medical and Health Research Council of Australia.

Role of the Sponsor: The National Medical and Health Research Council of Australia was not involved in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

Keywords

Adolescent
Age of Onset
Child
Female
Follow-Up Studies
Functional Residual Capacity
Humans
Infant
Logistic Models
Lung
Male
Respiratory Function Tests
Respiratory Sounds
Smoking
Spirometry

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Cite this

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title = "Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals",

abstract = " IMPORTANCE This is the first study to link reduced lung function in early life, before the development of symptoms, to wheeze in 18-year-olds. Additionally, the study gives insight into factors other than reduced lung function that are also associated with persistent wheeze in young adults.OBJECTIVE: To test the hypothesis that reduced lung function in early life is associated with increased risk for persistent wheeze at age 18 years.DESIGN: Birth cohort study.SETTING: Perth, Western Australia.PARTICIPANTS: Individuals followed up from age 1 month to 18 years.MAIN OUTCOME MEASURES: Maximal flow at functional residual capacity (V'maxFRC) was measured in 1-month-old infants who were followed up at ages 6, 12, and 18 years. Based on reported symptoms, individuals were categorized as having remittent wheeze, later-onset wheeze, persistent wheeze, and no wheeze. Smoking status was noted at age 18 years.RESULTS: Of the 253 individuals originally recruited, 150 were followed up at age 18 years; 37 of the 150 had recent wheeze. Compared with the no-wheeze group (n = 96), persistent wheeze (n = 13) was independently associated with reduced percentage of predicted V'maxFRC (mean reduction, 43%; 95% CI, 13-74). Compared with the no-wheeze group, persistent wheeze was also associated with atopy in infancy (odds ratio = 7.1; 95% CI, 1.5-34.5), maternal asthma (odds ratio = 6.8; 95% CI, 1.4-32.3), and active smoking (odds ratio = 4.8; 95% CI, 1.0-21.3). When only wheeze at age 18 years was considered, reduced percentage of predicted V'maxFRC was associated with wheeze at age 18 years only among current smokers (P = .04).CONCLUSIONS AND RELEVANCE: Wheeze persisting from ages 6 to 18 years is associated with multiple factors, including reduced infant lung function, infant-onset atopy, maternal asthma, and active smoking. Wheeze at age 18 years (regardless of previous wheeze status) is associated with active smoking, but only among those with reduced lung function in infancy. These findings give unique insight into the cause of obstructive airways disease in 18-year-olds, and follow-up of this cohort might be expected to further extend our understanding.",

keywords = "Adolescent, Age of Onset, Child, Female, Follow-Up Studies, Functional Residual Capacity, Humans, Infant, Logistic Models, Lung, Male, Respiratory Function Tests, Respiratory Sounds, Smoking, Spirometry",

author = "David Mullane and Turner, {Stephen William} and Cox, {Des W} and Jack Goldblatt and Landau, {Lou I} and {le Sou{\"e}f}, {Peter N}",

note = "Funding/Support: This work was supported by the National Medical and Health Research Council of Australia. Role of the Sponsor: The National Medical and Health Research Council of Australia was not involved in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.",

year = "2013",

month = apr,

doi = "10.1001/jamapediatrics.2013.633",

language = "English",

volume = "167",

pages = "368--73",

journal = "JAMA pediatrics",

issn = "2168-6211",

publisher = "American Medical Association",

number = "4",

}

TY - JOUR

T1 - Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals

AU - Mullane, David

AU - Turner, Stephen William

AU - Cox, Des W

AU - Goldblatt, Jack

AU - Landau, Lou I

AU - le Souëf, Peter N

N1 - Funding/Support: This work was supported by the National Medical and Health Research Council of Australia. Role of the Sponsor: The National Medical and Health Research Council of Australia was not involved in the design and conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript.

PY - 2013/4

Y1 - 2013/4

N2 - IMPORTANCE This is the first study to link reduced lung function in early life, before the development of symptoms, to wheeze in 18-year-olds. Additionally, the study gives insight into factors other than reduced lung function that are also associated with persistent wheeze in young adults.OBJECTIVE: To test the hypothesis that reduced lung function in early life is associated with increased risk for persistent wheeze at age 18 years.DESIGN: Birth cohort study.SETTING: Perth, Western Australia.PARTICIPANTS: Individuals followed up from age 1 month to 18 years.MAIN OUTCOME MEASURES: Maximal flow at functional residual capacity (V'maxFRC) was measured in 1-month-old infants who were followed up at ages 6, 12, and 18 years. Based on reported symptoms, individuals were categorized as having remittent wheeze, later-onset wheeze, persistent wheeze, and no wheeze. Smoking status was noted at age 18 years.RESULTS: Of the 253 individuals originally recruited, 150 were followed up at age 18 years; 37 of the 150 had recent wheeze. Compared with the no-wheeze group (n = 96), persistent wheeze (n = 13) was independently associated with reduced percentage of predicted V'maxFRC (mean reduction, 43%; 95% CI, 13-74). Compared with the no-wheeze group, persistent wheeze was also associated with atopy in infancy (odds ratio = 7.1; 95% CI, 1.5-34.5), maternal asthma (odds ratio = 6.8; 95% CI, 1.4-32.3), and active smoking (odds ratio = 4.8; 95% CI, 1.0-21.3). When only wheeze at age 18 years was considered, reduced percentage of predicted V'maxFRC was associated with wheeze at age 18 years only among current smokers (P = .04).CONCLUSIONS AND RELEVANCE: Wheeze persisting from ages 6 to 18 years is associated with multiple factors, including reduced infant lung function, infant-onset atopy, maternal asthma, and active smoking. Wheeze at age 18 years (regardless of previous wheeze status) is associated with active smoking, but only among those with reduced lung function in infancy. These findings give unique insight into the cause of obstructive airways disease in 18-year-olds, and follow-up of this cohort might be expected to further extend our understanding.

AB - IMPORTANCE This is the first study to link reduced lung function in early life, before the development of symptoms, to wheeze in 18-year-olds. Additionally, the study gives insight into factors other than reduced lung function that are also associated with persistent wheeze in young adults.OBJECTIVE: To test the hypothesis that reduced lung function in early life is associated with increased risk for persistent wheeze at age 18 years.DESIGN: Birth cohort study.SETTING: Perth, Western Australia.PARTICIPANTS: Individuals followed up from age 1 month to 18 years.MAIN OUTCOME MEASURES: Maximal flow at functional residual capacity (V'maxFRC) was measured in 1-month-old infants who were followed up at ages 6, 12, and 18 years. Based on reported symptoms, individuals were categorized as having remittent wheeze, later-onset wheeze, persistent wheeze, and no wheeze. Smoking status was noted at age 18 years.RESULTS: Of the 253 individuals originally recruited, 150 were followed up at age 18 years; 37 of the 150 had recent wheeze. Compared with the no-wheeze group (n = 96), persistent wheeze (n = 13) was independently associated with reduced percentage of predicted V'maxFRC (mean reduction, 43%; 95% CI, 13-74). Compared with the no-wheeze group, persistent wheeze was also associated with atopy in infancy (odds ratio = 7.1; 95% CI, 1.5-34.5), maternal asthma (odds ratio = 6.8; 95% CI, 1.4-32.3), and active smoking (odds ratio = 4.8; 95% CI, 1.0-21.3). When only wheeze at age 18 years was considered, reduced percentage of predicted V'maxFRC was associated with wheeze at age 18 years only among current smokers (P = .04).CONCLUSIONS AND RELEVANCE: Wheeze persisting from ages 6 to 18 years is associated with multiple factors, including reduced infant lung function, infant-onset atopy, maternal asthma, and active smoking. Wheeze at age 18 years (regardless of previous wheeze status) is associated with active smoking, but only among those with reduced lung function in infancy. These findings give unique insight into the cause of obstructive airways disease in 18-year-olds, and follow-up of this cohort might be expected to further extend our understanding.

KW - Adolescent

KW - Age of Onset

KW - Child

KW - Female

KW - Follow-Up Studies

KW - Functional Residual Capacity

KW - Humans

KW - Infant

KW - Logistic Models

KW - Lung

KW - Male

KW - Respiratory Function Tests

KW - Respiratory Sounds

KW - Smoking

KW - Spirometry

U2 - 10.1001/jamapediatrics.2013.633

DO - 10.1001/jamapediatrics.2013.633

M3 - Article

C2 - 23420147

SN - 2168-6211

VL - 167

SP - 368

EP - 373

JO - JAMA pediatrics

JF - JAMA pediatrics

IS - 4

ER -

Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals

Abstract

Bibliographical note

Keywords

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