Early life environmental control: effect on symptoms, sensitization, and lung function at age 3 years

Am J Respir Crit Care Med. 2004 Aug 15;170(4):433-9. doi: 10.1164/rccm.200401-083OC. Epub 2004 May 13.

Abstract

We investigated whether environmental control during pregnancy and early life affects sensitization and lung function at the age of 3 years. High-risk children (n = 251) were prenatally randomized to stringent environmental control (active) or no intervention (control). Questionnaires, skin testing, IgE, and specific airway resistance (sRaw) measurement were completed at the age of 3 years. Children in the active group were significantly more frequently sensitized compared with control subjects (at least one allergen by skin tests: risk ratio, 1.61; 95% confidence interval [CI], 1.02-2.55; p = 0.04; mite by IgE: risk ratio, 2.85; 95% CI, 1.02-7.97; p = 0.05). However, sRaw was significantly better in the active group (kiloPascal/second, geometric mean [95% CI]: 1.05 [1.01-1.10] vs. 1.19 [1.13-1.25], p < 0.0001, active vs. control). Maximal flow at functional residual capacity was measured using rapid thoracic compression at the age of 4 weeks in a subgroup. Prospective lung function data (at infancy and 3 years) were obtained in 32 children (14 active and 18 control). There was no difference in infant lung function between the groups, but at 3 years, sRaw was significantly lower in the active compared with control children (p = 0.003). Stringent environmental control was associated with increased risk of mite sensitization but better results for some measurements of lung function in high-risk children at the age of 3 years.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens / analysis*
  • Child, Preschool
  • Comorbidity
  • Dust / analysis
  • Environmental Exposure / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Hypersensitivity / diagnosis
  • Hypersensitivity / epidemiology*
  • Hypersensitivity / immunology*
  • Hypersensitivity / prevention & control
  • Immunoglobulin E / blood
  • Infant, Newborn
  • Lung Diseases, Obstructive / epidemiology
  • Lung Diseases, Obstructive / immunology
  • Male
  • Pregnancy
  • Prenatal Exposure Delayed Effects
  • Prospective Studies
  • Respiratory Function Tests
  • United Kingdom / epidemiology

Substances

  • Allergens
  • Dust
  • Immunoglobulin E