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Eur Respir J
2022 Oct 01;604:. doi: 10.1183/13993003.02395-2021.
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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 ER
,
Mensink-Bout SM
,
den Dekker HT
,
Ahluwalia TS
,
Annesi-Maesano I
,
Arshad SH
,
Baïz N
,
Barros H
,
von Berg A
,
Bisgaard H
,
Bønnelykke K
,
Carlsson CJ
,
Casas M
,
Chatzi L
,
Chevrier C
,
Dalmeijer G
,
Dezateux C
,
Duchen K
,
Eggesbø M
,
van der Ent C
,
Fantini M
,
Flexeder C
,
Frey U
,
Forastiere F
,
Gehring U
,
Gori D
,
Granell R
,
Griffiths LJ
,
Inskip H
,
Jerzynska J
,
Karvonen AM
,
Keil T
,
Kelleher C
,
Kogevinas M
,
Koppen G
,
Kuehni CE
,
Lambrechts N
,
Lau S
,
Lehmann I
,
Ludvigsson J
,
Magnus MC
,
Mélen E
,
Mehegan J
,
Mommers M
,
Nybo Andersen AM
,
Nystad W
,
Pedersen ESL
,
Pekkanen J
,
Peltola V
,
Pike KC
,
Pinot de Moira A
,
Pizzi C
,
Polanska K
,
Popovic M
,
Porta D
,
Roberts G
,
Santos AC
,
Schultz ES
,
Standl M
,
Sunyer J
,
Thijs C
,
Toivonen L
,
Uphoff E
,
Usemann J
,
Vafeidi M
,
Wright J
,
de Jongste JC
,
Jaddoe VWV
,
Duijts L
.
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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.
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