Effect of acute respiratory infections in infancy on pulmonary function test at 3 years of age: a prospective birth cohort study

Kumar, Prawin; Mukherjee, Aparna; Randev, Shivani; Medigeshi, Guruprasad R; Jat, Kana Ram; Kapil, Arti; Lodha, Rakesh; Kabra, Sushil Kumar

Chronic respiratory disease is a significant cause of morbidity in childhood and later life. 1 Epidemiological studies reveal that many of such chronic respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) in the adults may have their origin in the antenatal period and early childhood. [2] [3] [4] [5] It is a well-known fact that respiratory system continues to grow and develop in the postnatal period, especially during the first 3 years of life making this period exceptionally vulnerable to lung injury. [6] [7] [8] [9] In the last two decades, several innovative methods for the measurement of infant's pulmonary function have been developed and these are playing a vital role in the understanding of normal growth and development of lungs, as well as their longitudinal, follow-up from birth through childhood. 8 9 Longitudinal studies have revealed that lung function at birth and in the first 4-6 years of age tracks the lung function throughout life. 3 5 7 Acute respiratory infections (ARIs) during infancy may affect the normal development of the respiratory system which in turn may have an impact on pulmonary function test. 5 10-12 ARI during early life, especially with viral aetiology, can lead to development of asthma in childhood and COPD in adulthood. 2 3 13 14 Although infection with any of the respiratory viruses during infancy may contribute to the development of asthma and COPD in childhood and adulthood, most of the studies have Open access focused on respiratory syncytial virus (RSV) and rhinovirus (RV) infections. 5 10 13 15-17 Elucidating the effect of ARI on developing pulmonary function in infancy and its tracking in childhood and beyond is an exciting research area. It offers the possibility of identification of infants, who after an ARI episode, maybe at an increased risk of developing chronic respiratory diseases; strategies could then be studied in these infants for the prevention of chronic respiratory morbidity. 16 18 However, the majority of the available literature is on RSV and RV infection, lower respiratory tract infection (LRTI) and mainly from the Caucasian and Oriental populations. 4 10 13 14 16 19 There is a scarcity of data describing the association of all types of ARIs of any aetiology with the developing pulmonary functions measured by IPFT.