Early respiratory infections, asthma, and allergy: 10-year follow-up of the Oslo Birth Cohort

Per Nafstad, Bert Brunekreef, Anders Skrondal, Wenche Nystad
Pediatrics 2005, 116 (2): e255-62

OBJECTIVE: It has been hypothesized that early infections protect against the development of atopic disease, but there have been few long-term follow-up studies. We estimated the associations between early respiratory infections and doctor-diagnosed asthma, allergic rhinitis, and skin-prick sensitization in children at 10 years of age in the Oslo Birth Cohort, established in 1992-1993. We also considered birth order and attendance at a child care center as proxy measures of increased exposure to infections early in life.

METHODS: A total of 2540 children were followed from birth to the age of 10 years. Experiences of respiratory infections were recorded in follow-up surveys at 6 and 12 months. At age 10, questions were asked about current symptoms of asthma and allergic rhinitis and about having ever received a doctor diagnosis for these diseases. A subsample (n = 1740) of the cohort was tested for skin-prick test reactivity.

RESULTS: Current asthma was related to lower respiratory tract infection (adjusted odds ratio [OR]: 2.1; 95% confidence interval: 1.3-3.0) and croup (adjusted OR: 2.3; 95% confidence interval: 1.3-4.2) in the first year. ORs for allergic rhinitis and skin-prick sensitization were smaller but mainly positive. Birth order and child care attendance at age 1 year were not significantly associated with any of the studied outcomes.

CONCLUSIONS: Early respiratory infections did not protect against the development of asthma, allergic rhinitis, or sensitization to common allergens during the first 10 years of life but increased the risk for asthma symptoms at age 10 in this population.

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