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

Ashley Woodcock, Lesley A. Lowe, Clare S. Murray, Bridget M. Simpson, Spyros D. Pipis, Patricia Kissen, Angela Simpson, Adnan Custovic

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)433-439
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume170
Issue number4
DOIs
Publication statusPublished - 15 Aug 2004

Keywords

  • Asthma
  • Atopy
  • Environmental control
  • Lung function
  • Primary prevention

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