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

Research output: Contribution to journalArticle

29 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 languageEnglish
Pages (from-to)368-73
Number of pages6
JournalJAMA pediatrics
Volume167
Issue number4
Early online date18 Feb 2013
DOIs
Publication statusPublished - Apr 2013

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

Fingerprint Dive into the research topics of 'Reduced infant lung function, active smoking, and wheeze in 18-year-old individuals'. Together they form a unique fingerprint.

  • Cite this