Reduced Adult Airway Function after Wheezing Early in Life

Article Outline

• Rationale
• Methods
• Results
• Conclusions
• Copyright

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Rationale 

Wheezing during viral infections is common in infants and young children. Do these children have reduced airway function in early adulthood, and if so, what accounts for this? To analyze this we have compared airway function in early adulthood in subjects with wheezing in infancy with age-matched controls.

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Methods 

Asthma development has been prospectively studied in 101 children hospitalised 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 sensitisation. An age-matched population (n = 294) was used for comparison.

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Results 

The cohort had a significantly lower FEV₁/FVC ratio and MEF₅₀, 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 FEV₁/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, i.e. belonging to the cohort, was an independent risk factor for reduced pre-bronchodilation airway function, 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).

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Conclusions 

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.