Early childhood risk factors for decreased FEV1 at age six to seven years in young children with cystic fibrosis

Don B. Sanders, Julia Emerson, Clement L. Ren, Michael S. Schechter, Ronald L. Gibson, Wayne J Morgan, Margaret Rosenfeld

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Rationale: There are limited objective measures of the severity of lung disease before children are able to routinely perform spirometry, generally at age 6 years. Identifying risk factors for reduced lung function at age 6 provides opportunities to intervene and slow the progression of cystic fibrosis (CF) lung disease. Objectives: To evaluate early childhood predictors of lung function at age 6-7 in a large U.S. CF cohort in the current era of widespread early eradication therapy for Pseudomonas aeruginosa (P. aeruginosa). Methods: Participants were children with CF enrolled before age 4 in the Early Pseudomonas Infection Control (EPIC) Observational Study, a multicenter, longitudinal study that enrolled P. aeruginosa-negative children not exceeding 12 years of age. Linear regression was used to estimate the association between potential early childhood risk factors and the best FEV1%predicted at age 6-7 years. Measurements and Main Results: Four hundred and eightyfour children (of 1,797 enrolled in the EPIC Observational Study) met the eligibility criteria for this analysis. Mean (SD) age at enrollment was 2.0 (1.3) years. In a multivariable model adjusted for age at enrollment, the following risk factorswere significantly associatedwith lower mean (95% confidence interval) FEV1% predicted at age 6-7: weight percentile less than 10% during the year of enrollment (-5.3 [-9.1, -1.5]), P. aeruginosa positive during the year of enrollment (-2.8 [-5.7, 0.0]), crackles or wheeze during the year of enrollment (-5.7 [-9.4, -1.9]), mother's education of high school or less (-4.2 [-7.3, -1.2]), and mother smoked during pregnancy (-4.4 [-8.8, 0.1]). Conclusions: In this large U.S. cohort, we identified several early childhood risk factors for lower FEV1 at age 6-7 years, most of which are modifiable.

Original languageEnglish (US)
Pages (from-to)1170-1176
Number of pages7
JournalAnnals of the American Thoracic Society
Volume12
Issue number8
DOIs
StatePublished - Aug 1 2015

Fingerprint

Cystic Fibrosis
Pseudomonas aeruginosa
Pseudomonas Infections
Infection Control
Lung Diseases
Observational Studies
Mothers
Lung
Spirometry
Respiratory Sounds
Secondary Prevention
Multicenter Studies
Longitudinal Studies
Linear Models
Confidence Intervals
Education
Weights and Measures
Pregnancy

Keywords

  • Cystic fibrosis
  • Lung function
  • Microbiology
  • Tobacco smoke pollution

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Early childhood risk factors for decreased FEV1 at age six to seven years in young children with cystic fibrosis. / Sanders, Don B.; Emerson, Julia; Ren, Clement L.; Schechter, Michael S.; Gibson, Ronald L.; Morgan, Wayne J; Rosenfeld, Margaret.

In: Annals of the American Thoracic Society, Vol. 12, No. 8, 01.08.2015, p. 1170-1176.

Research output: Contribution to journalArticle

Sanders, Don B. ; Emerson, Julia ; Ren, Clement L. ; Schechter, Michael S. ; Gibson, Ronald L. ; Morgan, Wayne J ; Rosenfeld, Margaret. / Early childhood risk factors for decreased FEV1 at age six to seven years in young children with cystic fibrosis. In: Annals of the American Thoracic Society. 2015 ; Vol. 12, No. 8. pp. 1170-1176.
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T1 - Early childhood risk factors for decreased FEV1 at age six to seven years in young children with cystic fibrosis

AU - Sanders, Don B.

AU - Emerson, Julia

AU - Ren, Clement L.

AU - Schechter, Michael S.

AU - Gibson, Ronald L.

AU - Morgan, Wayne J

AU - Rosenfeld, Margaret

PY - 2015/8/1

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N2 - Rationale: There are limited objective measures of the severity of lung disease before children are able to routinely perform spirometry, generally at age 6 years. Identifying risk factors for reduced lung function at age 6 provides opportunities to intervene and slow the progression of cystic fibrosis (CF) lung disease. Objectives: To evaluate early childhood predictors of lung function at age 6-7 in a large U.S. CF cohort in the current era of widespread early eradication therapy for Pseudomonas aeruginosa (P. aeruginosa). Methods: Participants were children with CF enrolled before age 4 in the Early Pseudomonas Infection Control (EPIC) Observational Study, a multicenter, longitudinal study that enrolled P. aeruginosa-negative children not exceeding 12 years of age. Linear regression was used to estimate the association between potential early childhood risk factors and the best FEV1%predicted at age 6-7 years. Measurements and Main Results: Four hundred and eightyfour children (of 1,797 enrolled in the EPIC Observational Study) met the eligibility criteria for this analysis. Mean (SD) age at enrollment was 2.0 (1.3) years. In a multivariable model adjusted for age at enrollment, the following risk factorswere significantly associatedwith lower mean (95% confidence interval) FEV1% predicted at age 6-7: weight percentile less than 10% during the year of enrollment (-5.3 [-9.1, -1.5]), P. aeruginosa positive during the year of enrollment (-2.8 [-5.7, 0.0]), crackles or wheeze during the year of enrollment (-5.7 [-9.4, -1.9]), mother's education of high school or less (-4.2 [-7.3, -1.2]), and mother smoked during pregnancy (-4.4 [-8.8, 0.1]). Conclusions: In this large U.S. cohort, we identified several early childhood risk factors for lower FEV1 at age 6-7 years, most of which are modifiable.

AB - Rationale: There are limited objective measures of the severity of lung disease before children are able to routinely perform spirometry, generally at age 6 years. Identifying risk factors for reduced lung function at age 6 provides opportunities to intervene and slow the progression of cystic fibrosis (CF) lung disease. Objectives: To evaluate early childhood predictors of lung function at age 6-7 in a large U.S. CF cohort in the current era of widespread early eradication therapy for Pseudomonas aeruginosa (P. aeruginosa). Methods: Participants were children with CF enrolled before age 4 in the Early Pseudomonas Infection Control (EPIC) Observational Study, a multicenter, longitudinal study that enrolled P. aeruginosa-negative children not exceeding 12 years of age. Linear regression was used to estimate the association between potential early childhood risk factors and the best FEV1%predicted at age 6-7 years. Measurements and Main Results: Four hundred and eightyfour children (of 1,797 enrolled in the EPIC Observational Study) met the eligibility criteria for this analysis. Mean (SD) age at enrollment was 2.0 (1.3) years. In a multivariable model adjusted for age at enrollment, the following risk factorswere significantly associatedwith lower mean (95% confidence interval) FEV1% predicted at age 6-7: weight percentile less than 10% during the year of enrollment (-5.3 [-9.1, -1.5]), P. aeruginosa positive during the year of enrollment (-2.8 [-5.7, 0.0]), crackles or wheeze during the year of enrollment (-5.7 [-9.4, -1.9]), mother's education of high school or less (-4.2 [-7.3, -1.2]), and mother smoked during pregnancy (-4.4 [-8.8, 0.1]). Conclusions: In this large U.S. cohort, we identified several early childhood risk factors for lower FEV1 at age 6-7 years, most of which are modifiable.

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KW - Microbiology

KW - Tobacco smoke pollution

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