Increased Asthma Risk and Impaired Quality of Life After Bronchiolitis or Pneumonia in Infancy

BackgroundRecent studies have revealed that adulthood asthma has its origin in early childhood. AimThe aim of the present study was to evaluate the prevalence of asthma and respiratory health-related quality of life in adults 30 years after hospitalization for bronchiolitis or pneumonia in infancy. MethodsPatients who were hospitalized for bronchiolitis or pneumonia at age under 24 months in 1981-1982 have been followed in repeated visits. In 2010, 48 of the 83 former patients with bronchiolitis (57.8%), 22 of the 44 former patients with pneumonia (50.0%), and 138 matched controls participated in the clinical study at the age of 28-31 years. The participants completed a structured questionnaire on respiratory symptoms, the Saint George's Respiratory Questionnaire (SGRQ), and underwent 2-week peak expiratory flow (PEF) monitoring. Asthma was defined as doctor-diagnosed and self-reported asthma based on doctor-prescribed medication for asthma, the presence of asthma-presumptive symptoms, and the results of home PEF monitoring. ResultsBoth doctor-diagnosed asthma (31.3% vs. 10.9% adjusted P=0.002) and self-reported asthma (35.4% vs. 14.5% 0.003), as well as repeated on-demand use of bronchodilators (35.4% vs. 14.5% 0.002), and regular use of inhaled corticosteroids (20.8% vs. 8.7% 0.023) were more common in former bronchiolitis patients than in controls. Former bronchiolitis and pneumonia patients had higher total SGRQ scores than controls. The median scores were 5.4 (IQ(25-75) 0.0-14.7, P<0.001) in bronchiolitis group, 4.9 (1.3-14.8, 0.012) in pneumonia group compared to controls 1.5 (0.0-6.0). ConclusionHospitalization for bronchiolitis in infancy is associated with an increased risk of asthma, and an increased use of asthma medication in adulthood at the age of 28-31 years. Impaired respiratory health-related quality of life in adulthood as measured by the SGRQ is present after bronchiolitis and pneumonia in infancy. Pediatr Pulmonol. 2014; 49:318-325. (c) 2013 Wiley Periodicals, Inc.