Early wheeze as reported by mothers and lung function in 4-year-olds. Prospective cohort study in Krakow.

Summary. The purpose of the study was to check the hypothesis that early wheezing as reported by mothers would be associated with reduced lung function in 4-year olds. Study participants were recruited prenatally, as part of a prospective cohort study on the respiratory health of young children exposed to various ambient air pollutants. After delivery, infants were followed over 4 years and the interviewers visited participants at their home to record respiratory symptoms every 3months in the child’s first 2 years of life and every 6 months in the 3rd and 4th years. In the 4th year of follow-up, children were invited for standard lung function testing by spirometry quantified by forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), and forced expiratory volume in 0.5 sec (FEV0.5) levels. Out of 258 children attending spirometry testing 139 performed at least two acceptable exhalation efforts. Cohort children with acceptable spirometric measurements did not differ with respect to wheezing experience and exposure characteristics from those without. The study shows that episodicwheezewas reported in 28.1%of 4-year olds, 6.5% had transientwheeze, and 4.3%had recurrentwheeze. Therewasanincreased frequency ofwheezing symptoms and their
duration in transient and recurrent wheezers. Adjusted multivariable regression models for gender and height showed that children who reportedmore than two episodes ofwheezing at any point over the follow-up had FVC values lower by 120.5ml (P=0.016) and FEV1 values lower by 98.3ml (P=0.034) compared to those who did not report any wheezing; children experiencing more than 10 wheezing days by age 4 showed FVC deficit of 87.4 ml (P=0.034) and FEV1 values of 65.7ml (P=0.066). The ratios of FEV1/FVC%, and FEV0.5/FVC% were neither associated with wheezing episodes norwheezing days. In recurrentwheezers, lung function decrement amounted to 207ml of FVC, 175ml of FEV1, and 104ml of FEV0.5. In conclusion, our findings show that wheezing experience during early postnatal life may be associated with lung function deficit of restrictive character in preschool children and detailed history ofwheeze in early postnatal life, even though not physician-confirmed, may help define the high risk group of children for poor lung function testing.

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