Acute lower respiratory illness in childhood as a predictor of lung function and chronic respiratory symptoms

Am Rev Respir Dis. 1989 Oct;140(4):877-84. doi: 10.1164/ajrccm/140.4.877.


This study investigated the relationship of acute lower respiratory illness (LRI) to level and change in level of forced expiratory volumes in a cohort of 801 children, followed longitudinally for a maximum of 13 yr. The co-occurrence of respiratory illness before 2 yr of age and two or more LRI during a single surveillance year was associated with a 20.3% lower mean cross-sectional level of FEF25-75, and with reduced longitudinal change in level of FEF25-75. The effect of LRI on lung function was uniformly stronger for boys than for girls. Of the children with illness before 2 yr of age and two or more LRI, six of 14 were male asthmatics with mean levels of FEF25-75 that were lower than those of other asthmatic children. Pneumonia and/or hospitalization for respiratory illness prior to the onset of study were associated with lower cross-sectional levels of forced expiratory volumes at entry to the study, even when asthmatics/persistent wheezers were eliminated from the analysis (6.1% lower level of FEV1 for a nonasthmatic boy with previous hospitalization versus a nonasthmatic boy without hospitalization). In the longitudinal analysis, pneumonia and/or hospitalization were associated with slower increase in level of forced expiratory volumes, even after adjusting for "ever diagnosis of asthma/current any wheeze" (starting at the same leve, after eight years a boy with hospitalization would develop a 5.0% lower FEV1 than a boy without hospitalization). Acute LRI also was evaluated as a predictor of chronic respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Asthma / epidemiology
  • Child
  • Child, Hospitalized
  • Child, Preschool
  • Cohort Studies
  • Female
  • Forced Expiratory Flow Rates
  • Forced Expiratory Volume
  • Humans
  • Longitudinal Studies
  • Lung / physiopathology*
  • Lung Diseases / complications*
  • Lung Diseases / epidemiology
  • Lung Diseases, Obstructive / etiology*
  • Male
  • Pneumonia / epidemiology
  • Probability
  • Prospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Vital Capacity