RT Journal Article
SR Electronic
T1 Determinants of early-life lung function in African infants
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 445
OP 450
DO 10.1136/thoraxjnl-2015-207401
VO 72
IS 5
A1 Diane Gray
A1 Lauren Willemse
A1 Ane Visagie
A1 Dorottya Czövek
A1 Polite Nduru
A1 Aneesa Vanker
A1 Dan J Stein
A1 Nastassja Koen
A1 Peter D Sly
A1 Zoltán Hantos
A1 Graham L Hall
A1 Heather J Zar
YR 2017
UL http://thorax.bmj.com/content/72/5/445.abstract
AB Background Low lung function in early life is associated with later respiratory illness. There is limited data on lung function in African infants despite a high prevalence of respiratory disease.Aim To assess the determinants of early lung function in African infants.Method Infants enrolled in a South African birth cohort, the Drakenstein child health study, had lung function measured at 6–10 weeks of age. Measurements, made with the infant breathing via a facemask during natural sleep, included tidal breathing, sulfur hexafluoride multiple breath washout and the forced oscillation technique. Information on antenatal and early postnatal exposures was collected using questionnaires and urine cotinine. Household benzene exposure was measured antenatally.Results Successful tests were obtained in 645/675 (95%) infants, median (IQR) age of 51 (46–58) days. Infant size, age and male gender were associated with larger tidal volume. Infants whose mothers smoked had lower tidal volumes (−1.6 mL (95% CI −3.0 to −0.1), p=0.04) and higher lung clearance index (0.1 turnovers (95% CI 0.01 to 0.3), p=0.03) compared with infants unexposed to tobacco smoke. Infants exposed to alcohol in utero or household benzene had lower time to peak tidal expiratory flow over total expiratory time ratios, 10% (95% CI −15.4% to −3.7%), p=0.002) and 3.0% (95% CI −5.2% to −0.7%, p=0.01) lower respectively compared with unexposed infants. HIV-exposed infants had higher tidal volumes (1.7 mL (95% CI 0.06 to 3.3) p=0.04) compared with infants whose mothers were HIV negative.Conclusion We identified several factors including infant size, sex, maternal smoking, maternal alcohol, maternal HIV and household benzene associated with altered early lung function, many of which are factors amenable to public health interventions. Long-term study of lung function and respiratory disease in these children is a priority to develop strategies to strengthen child health.