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Reduced airway function in early adulthood among subjects with wheezing disorder before two years of age.

Journal article
Authors Emma Goksör
Per M. Gustafsson
Bernt Alm
Mainor Åmark
Göran Wennergren
Published in Pediatric pulmonology
Volume 43
Issue 4
Pages 396-403
ISSN 1099-0496
Publication year 2008
Published at Institute of Clinical Sciences
Pages 396-403
Language en
Links dx.doi.org/10.1002/ppul.20798
Keywords Adolescent, Adult, Asthma, diagnosis, epidemiology, Bronchial Hyperreactivity, diagnosis, epidemiology, Cohort Studies, Female, Follow-Up Studies, Forced Expiratory Volume, Humans, Infant, Lung, physiopathology, Male, Maximal Expiratory Flow Rate, Odds Ratio, Predictive Value of Tests, Pregnancy, Prospective Studies, Respiratory Sounds, physiopathology, Risk Factors, Sex Distribution, Spirometry, Time, Tobacco Smoke Pollution, adverse effects, Vital Capacity
Subject categories Respiratory Medicine and Allergy, Pediatrics

Abstract

AIM: To compare airway function in early adulthood in subjects with wheezing in infancy with age-matched controls and to analyze what accounts for a possible difference. METHODS: Asthma development has been prospectively studied in 101 children hospitalized due to wheezing before the age of two. The cohort was re-investigated at age 17-20 years and tested with spirometry and for bronchial hyper-responsiveness and allergic sensitization. An age-matched population (n = 294) was used for comparison. RESULTS: The cohort had a significantly lower FEV(1)/FVC ratio and MEF(50), both pre- and post-bronchodilation, compared with the controls, P < 0.01. The reduction in airway function was most evident in current asthmatic female subjects, but a reduced pre-bronchodilation FEV(1)/FVC ratio was also seen in symptom-free cohort subjects, P = 0.03. In the multivariate analysis, female gender was the most prominent independent risk factor for reduced airway function in early adulthood, pre-bronchodilation OR 4.0 (1.4-11.3) and post-bronchodilation OR 8.8 (1.8-42.0). In addition, a history of early wheezing, that is, belonging to the cohort, was an independent risk factor for reduced airway function pre-bronchodilation, OR 3.3 (1.3-8.7). Furthermore, there was an association between current bronchial hyper-responsiveness and an increased risk of reduced airway function post-bronchodilation, OR 7.3 (2.0-26.6). CONCLUSION: Reduced airway function in early adulthood was found in subjects with wheezing early in life, compared with age-matched controls. The reduction was most prominent in females with current asthma.

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