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Lung function at school age in infants with lower respiratory tract infections with and without wheezing: a birth cohort study.
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  • Franca Rusconi,
  • Enrico Lombardi,
  • Elena Spada,
  • Sonia Brescianini,
  • Martina Culasso,
  • Francesca Di Toro,
  • Antonella Frassanito,
  • Lorenzo Richiardi,
  • Luca Ronfani,
  • Ileana Stella,
  • Luigi Gagliardi
Franca Rusconi
Azienda USL Toscana nord ovest

Corresponding Author:franca.rusconi@uslnordovest.toscana.it

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Enrico Lombardi
Meyer Pediatric University Hospital
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Elena Spada
1 Epidemiology Unit, Meyer Children’s University Hospital, Florence, Italy
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Sonia Brescianini
Istituto Superiore di Sanità
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Martina Culasso
Department of Epidemiology of the Regional Health Service Lazio
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Francesca Di Toro
IRCCS Materno Infantile Burlo Garofolo
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Antonella Frassanito
Policlinico Umberto I
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Lorenzo Richiardi
University of Turin
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Luca Ronfani
IRCCS Materno Infantile Burlo Garofolo
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Ileana Stella
Maria Vittoria Hospital
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Luigi Gagliardi
Azienda USL Toscana nord ovest Sede Pisa
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Abstract

Objective: To evaluate the relationship between lower respiratory tract infections (LRTI), in the first 2 years of life and lung function at school age in the Piccolipiù birth cohort (Italy). Methods: Data on LRTI (doctor diagnosis of bronchitis, bronchiolitis, pneumonia) and wheezing (≥3 episodes or a diagnosis of asthmatic bronchitis) in the first 2 years of life were obtained from parental questionnaires. Lung function was assessed at 7 years by spirometry and forced volume vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, forced expiratory flow between 25 and 75%, and at 75% of FVC (FEF25-75 and FEF75) were reported as z-scores. The associations between LRTI and spirometric variables were estimated with linear regression models. Results: Among 877 children studied, 22.1% had LRTI only, 5.4% wheezing only, 13.2% had both, and 59.3% had neither LRTI nor wheezing. Children with LRTI had lower FVC and FEV1 than children without (z-score differences: -0.18 (95% Confidence Intervals, -0.31; -0.06) and -0.15 ( 0.27; -0.03)). When children were stratified by history of both LRTI and wheezing, there was no association between LRTI only and spirometric values. Conversely, having had both LRTI and wheezing was inversely associated with all lung function measures: z-score differences of -0.24 ( 0.42; -0.07); -0.42 (-0.59; -0.24); -0.25 (-0.41; -0.08); -0.37 (-0.54; -0.21); -0.30 (-0.46; -0.14) for FVC, FEV1, FEV1/FVC, FEF25-75 and FEF75, respectively. Conclusion: Infants with wheezing and LRTI, but not those with LRTI only, had reduced lung function at school-age.
01 Nov 2021Submitted to Pediatric Pulmonology
02 Nov 2021Submission Checks Completed
02 Nov 2021Assigned to Editor
12 Nov 2021Reviewer(s) Assigned
01 Jan 2022Review(s) Completed, Editorial Evaluation Pending
01 Jan 2022Editorial Decision: Revise Minor
04 Jan 20221st Revision Received
05 Jan 2022Submission Checks Completed
05 Jan 2022Assigned to Editor
05 Jan 2022Reviewer(s) Assigned
18 Jan 2022Review(s) Completed, Editorial Evaluation Pending
18 Jan 2022Editorial Decision: Accept
Apr 2022Published in Pediatric Pulmonology volume 57 issue 4 on pages 857-861. 10.1002/ppul.25835