Lung function measurements in children - copsac
Lung function measurements in children - copsac
Lung function measurements in children - copsac
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<strong>in</strong>fants who later develop RSV bronchiolitis and <strong>in</strong>fants who do not develop RSV<br />
bronchiolitis. The risk factors for neonatal lung <strong>function</strong> was studied <strong>in</strong> the COPSAC<br />
cohort <strong>in</strong> a recent publication (135). The study showed that high body mass <strong>in</strong>dex <strong>in</strong><br />
newborns and mothers smok<strong>in</strong>g were associated with reduced lung <strong>function</strong>; and<br />
parental atopic disease (mother’s or father’s eczema, urticaria or allergic rh<strong>in</strong>itis or<br />
father’s asthma) did not affect the neonatal lung <strong>function</strong> and bronchial responsiveness.<br />
More <strong>in</strong>terest<strong>in</strong>gly, there was a parabola (<strong>in</strong>creas<strong>in</strong>g) development of bronchial<br />
responsiveness peak<strong>in</strong>g at 3 months of age (though with few subjects at the later time<br />
po<strong>in</strong>ts), which could co<strong>in</strong>cides with hospitalization for acute viral bronchiolitis.<br />
In our study group of <strong>in</strong>fants less than 2 years of age the mean age of the <strong>in</strong>fants<br />
diagnosed with RSV bronchiolitis was 8 months (174). Other studies have limited the<br />
group of <strong>in</strong>terest to <strong>children</strong> less than 12 months of age and accord<strong>in</strong>gly reported even<br />
lower age of RSV <strong>in</strong>fection (113, 114, 143, 144, 200).<br />
The <strong>in</strong>cidence of bronchiolits (5%) was higher than reported <strong>in</strong> most studies (1-3%) (77-<br />
79, 81, 140, 201). This suggests a genetic component <strong>in</strong> RSV bronchiolitis as all<br />
mothers had asthma. Predisposition to asthma and atopy has been associated with<br />
<strong>in</strong>creased risk of lower respiratory tract <strong>in</strong>fection and hospitalization for RSV <strong>in</strong>fection<br />
(112, 113, 116). Young et al. found 7% of a cohort (253 <strong>in</strong>fants) with the diagnosis of<br />
bronchiolitis before 2 years of age (only 2 <strong>in</strong>fants were hospitalized and confirmed for<br />
RSV <strong>in</strong>fection); 71% had a family history of atopy (110). A Danish case-control study<br />
has also supported that asthmatic disposition and wheez<strong>in</strong>g were strong determ<strong>in</strong>ants of<br />
subsequent respiratory syncytial virus hospitalization <strong>in</strong> <strong>children</strong>