Early childhood infectious diseases and the development of asthma up to school age: a birth cohort study

Abstract

Objective: To investigate the association between early childhood infections and subsequent development of asthma.

Design: Longitudinal birth cohort study.

Setting: Five children's hospitals in five German cities.

Participants: 1314 children born in 1990 followed from birth to the age of 7 years.

Main outcome measures: Asthma and asthmatic symptoms assessed longitudinally by parental questionnaires; atopic sensitisation assessed longitudinally by determination of IgE concentrations to various allergens; bronchial hyperreactivity assessed by bronchial histamine challenge at age 7 years.

Results: Compared with children with </=1 episode of runny nose before the age of 1 year, those with >/=2 episodes were less likely to have a doctor's diagnosis of asthma at 7 years old (odds ratio 0.52 (95% confidence interval 0.29 to 0.92)) or to have wheeze at 7 years old (0.60 (0.38 to 0.94)), and were less likely to be atopic before the age of 5 years. Similarly, having >/=1 viral infection of the herpes type in the first 3 years of life was inversely associated with asthma at age 7 (odds ratio 0.48 (0.26 to 0.89)). Repeated lower respiratory tract infections in the first 3 years of life showed a positive association with wheeze up to the age of 7 years (odds ratio 3.37 (1.92 to 5.92) for >/=4 infections v </=3 infections).

Conclusion: Repeated viral infections other than lower respiratory tract infections early in life may reduce the risk of developing asthma up to school age.

Figure

Longitudinal analysis of repeated episodes (⩾2) of runny nose in the first year of life and 12 month prevalences of wheeze up to the age of 7 years. Values are odds ratios with 95% confidence intervals adjusted for parental education, high risk of atopy at birth, parental smoking at birth, and age