Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
: van Meel Evelien R., Mensink-Bout Sara M., den Dekker Herman T., Ahluwalia Tarunveer S., Annesi-Maesano Isabella, Arshad Syed Hasan, Baïz Nour, Barros Henrique, von Berg Andrea, Bisgaard Hans, Bønnelykke Klaus, Carlsson Christian J., Casas Maribel, Chatzi Leda, Chevrier Cecile, Dalmeijer Geertje, Dezateux Carol, Duchen Karel, Eggesbø Merete, van der Ent Cornelis, Fantini Maria, Flexeder Claudia, Frey Urs, Forastiere Fransesco, Gehring Ulrike, Gori Davide, Granell Raquel, Griffiths Lucy J., Inskip Hazel, Jerzynska Joanna, Karvonen Anne M., Keil Thomas, Kelleher Cecily, Kogevinas Manolis, Koppen Gudrun, Kuehni Claudia E., Lambrechts Nathalie, Lau Susanne, Lehmann Irina, Ludvigsson Johnny, Magnus Maria Christine, Mélen Erik, Mehegan John, Mommers Monique, Andersen Anne-Marie Nybo, Nystad Wenche, Pedersen Eva S.L., Pekkanen Juha, Peltola Ville, Pike Katharine C., de Moira Angela Pinot, Pizzi Costanza, Polanska Kinga, Popovic Maja, Porta Daniela, Roberts Graham, Santos Ana Cristina, Schultz Erica S., Standl Marie, Sunyer Jordi, Thijs Carel, Toivonen Laura, Uphoff Eleonora, Usemann Jakob, Vafeidi Marina, Wright John, de Jongste Johan C., Jaddoe Vincent W.V., Duijts Liesbeth
Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD
: Sheffield
: 2022
: European Respiratory Journal
: EUROPEAN RESPIRATORY JOURNAL
: EUR RESPIR J
: 2102395
: 60
: 4
: 13
: 0903-1936
: 1399-3003
DOI: https://doi.org/10.1183/13993003.02395-2021
: https://erj.ersjournals.com/content/60/4/2102395
: https://research.utu.fi/converis/portal/detail/Publication/177914861
Background: Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.
Methods: We used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4-15) years.
Results: Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: -0.09 (95% CI -0.14- -0.04) to -0.30 (95% CI -0.36- -0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98-2.22) to 6.30 (95% CI 5.64-7.04) and 1.25 (95% CI 1.18-1.32) to 1.55 (95% CI 1.47-1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.
Conclusions: Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.
