Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
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.
van Meel, Evelien R.
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Mensink-Bout, Sara M.
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den Dekker, Herman T.
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Ahluwalia, Tarunveer S.
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Annesi-Maesano, Isabella
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Arshad, Syed Hasan
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Barros, Henrique
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von Berg, Andrea
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Bisgaard, Hans
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Carlsson, Christian J.
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van Meel, Evelien R.
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Mensink-Bout, Sara M.
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den Dekker, Herman T.
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Barros, Henrique
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von Berg, Andrea
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Bisgaard, Hans
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van der Ent, Cornelis
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Gehring, Ulrike
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Jerzynska, Joanna
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Ludvigsson, Johnny
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