Resumo

MUTTOO, S et al. Low birthweight and maternal smoking as predictors of infant lung function from a South African birth cohort within low socioeconomic communities. S. Afr. j. child health [online]. 2023, vol.17, n.4, pp.174-180. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2023.v17i4.1957.

BACKGROUND: Early assessment of infant lung function (ILF) is necessary to improve our understanding of factors that determine long-term respiratory health. OBJECTIVE: To identify predictors of lung function among infants aged 6 weeks, 6, 12 and 24 months, from low socioeconomic settings, enrolled within the Mother and Child in the Environment (MACE) study. METHODS: ILF tests were performed assessing multiple breath washout and tidal breathing during spontaneous sleep. Several risk factors, relating to infant growth, maternal and environmental exposures, were assessed cross-sectionally against the lung function parameters in multivariable models for each age group. RESULTS: Maternal smoking during pregnancy affected the ratio of time to peak expiratory flow, showing a decline across the age groups, while being statistically significant (β (95% confidence interval (CI)) at 6 weeks (-24.6% (-43.92 -4.59)) and 12 months (-12.68 (-25.25 - -0.11)). Low birthweight was associated with a lower tidal volume at 6 weeks (-5.99 mL (-9.59 - -2.39)), 6 months (-15.02 mL (-22.48 -7.57)) and 12 months (-23.7 mL (-35.55 -11.85)), compared with those with normal birthweight. This was further observed for minute ventilation at 6 weeks (-157.78 mL/min (-338.95 - 23.38)), 6 months (-325.57 mL/min (-619.06 --32.08)) and 12 months (-527.58 mL/min (-947.85 - -107.32)), though less evident at 24 months. CONCLUSION: Low birthweight was the main predictor for low tidal volumes and minute ventilation at 6 weeks, with smaller differences observed at 12 and 24 months. Lung function development early in life is primarily driven by infant size and postnatal growth factors, consistent with other studies.

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