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Early life environmental control: effect on symptoms, sensitization, and lung function at age 3 years.
Woodcock AA, Lowe L, Murray CS, Simpson B, Pipis S, Kissen P, Simpson A, Custovic A, NAC Manchester Asthma and Allergy Study Group
Am J Respir Crit Care Med. 2004;170( 4).
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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 stringentenvironmental 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 activegroup were significantly more frequently sensitized compared with controlsubjects (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 betterin 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 rapidthoracic compression at the age of 4 weeks in a subgroup. Prospective lungfunction data (at infancy and 3 years) were obtained in 32 children (14active and 18 control). There was no difference in infant lung functionbetween the groups, but at 3 years, sRaw was significantly lower in theactive compared with control children (p = 0.003). Stringent environmentalcontrol was associated with increased risk of mite sensitization butbetter results for some measurements of lung function in high-riskchildren at the age of 3 years.
Keyword(s)
Child, Preschool; Comorbidity; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Pregnancy; Prenatal Exposure Delayed Effects; Prospective Studies; Research Support, Non-U.S. Gov't; Respiratory Function Tests; analysis: Allergens; analysis: Dust; blood: Immunoglobulin E; diagnosis: Hypersensitivity; epidemiology: Great Britain; epidemiology: Lung Diseases, Obstructive; statistics & numerical data: Environmental Exposure