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Original article
A longitudinal study of lung function from 1 month to 18 years of age
  1. Steve Turner1,
  2. Shona Fielding2,
  3. Dave Mullane3,
  4. Des W Cox3,
  5. Jack Goldblatt3,
  6. Lou Landau3,
  7. Peter le Souef3
  1. 1Department of Child Health, University of Aberdeen, Aberdeen, UK
  2. 2Medical Statistics Team, University of Aberdeen, Aberdeen, UK
  3. 3School of Child Health, University of Western Australia, Perth, Australia
  1. Correspondence to Dr Steve Turner, Department of Child Health, University of Aberdeen, Royal Aberdeen Children's Hospital, Foresterhill, Aberdeen AB25 2ZG, UK; s.w.turner{at}abdn.ac.uk

Abstract

Background Our hypothesis was that factors associated with wheeze will be associated with changes in lung function trajectory between 1 month and 18 years of age.

Methods Measurements of lung function were made in individuals aged 1, 6 and 12 months (V'maxFRC), and also at ages 6, 12 and 18 years (FEF25–75). Changes in lung function over time relative to sex, a history of asthma, maternal asthma and other factors were explored using random coefficient models.

Results Lung function (maximal flow at functional residual capacity in infants and FEF25–75 in children) was determined in 241 individuals at 1 month, 192 at 6 months, 164 at 12 months, 106 at 6 years, 183 at 12 years and 141 at 18 years. In the multivariable model, maternal asthma (mean reduction in lung function 9.8%), flow limitation (mean reduction 17.4%), infant atopy (mean reduction 12.6%) and maternal smoking (mean reduction in lung function 8.1%) were acting independently. When interactions with time were sought, the reduction in lung function associated with maternal asthma and infant atopy were consistent over time, but % lung function increased in boys by a mean of 1%/year compared with girls, in flow-limited individuals by 3.0%/year and by 0.9%/year for those exposed to maternal smoking during pregnancy compared to other cohort members.

Conclusions Decrements in lung function in 18-year-olds associated with maternal asthma and early onset atopy may be determined by 1 month of age. Low initial lung function in some individuals can ‘recover’ in some settings.

  • Asthma Mechanisms
  • Paediatric asthma

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