Lower respiratory illness in childhood is associated with later development of asthma and wheeze that can persist into adulthood, and that are considered risk factors for adult chronic obstructive pulmonary disease, a prospective study has found.
Researchers assessed the lung function of 646 children – 338 of whom had experienced lower respiratory illness (LRI) before age 2 and 308 controls – and found those who had early pneumonia had a nearly twofold increase in the risk of asthma and wheeze up to age 26.
They also had the most severe subsequent deficits in lung function, while those with early nonpneumonia LRI had smaller but still significant impairments in lung function and an increased risk of wheeze, according to a report published online March 2 in Pediatrics (2015;135 [doi:10.1542/peds.2014-3060]).
The children who were included in this study were part of a birth cohort of 1,246 healthy infants enrolled between 1980 and 1984 in the Tucson Children’s Respiratory Study .
Participants included in the current study were required to have complete follow-up for LRIs during the first 3 years of life and to have at least one pulmonary function test completed at ages 11, 16, 22, or 26 years.
Physician-diagnosed asthma with active symptoms and active wheeze during the previous year were assessed prospectively by questionnaires completed by the participant’s parents at ages 11, 13, and 16 years and by the participant at ages 18, 22, 24, 26, and 29 years, according to the researchers.
After the investigators adjusted for covariates, participants with early pneumonia had a significantly higher risk of active physician-diagnosed asthma (odds ratio: 1.95; 95% confidence interval: 1.11-3.44) during the previous year up to age 29 years, compared with those with no LRI during early life.
Early pneumonia was also associated with a significantly increased risk of active wheeze during the previous year up to age 29 years (OR: 1.94; 95% CI: 1.28-2.95) as were other LRIs, although the association with the latter was much weaker than that for pneumonia (OR: 1.37; 95% CI: 1.09-1.72), according to the authors.
“Because there is considerable evidence that asthma associated with airflow limitation is a strong risk factor for subsequent chronic obstructive pulmonary disease, the prevention of early-life pneumonia and of the factors that determine low lung function in infancy may contribute significantly to decrease the public health burden of chronic obstructive pulmonary disease,” wrote Dr. Johnny Y.C. Chan of Kwong Wah Hospital, Kowloon, Hong Kong, and the University of Arizona, Tucson, and his coauthors.
The study was funded by the National Institutes of Health, and no conflicts of interest were declared.