Babies suffer later effects of lung disease

BEING infected with pneumonia in the first few months of life nearly doubles an infant’s chance of having lower lung function at the age of one, a new study has found.

UCT doctoral research, conducted by Red Cross War Memorial Children’s Hospital paediatrician Diane Gray, aimed to identify antenatal and early life factors that impact on infants’ lung function and growth in a bid to prevent acute and chronic respiratory diseases.

Although similar studies have been done in affluent countries, this was a first of its kind in Africa.

The study found that maternal smoking, alcohol intake during pregnancy, and indoor air pollution have an impact on infants’ lung function and growth.

The study also found that being exposed to household smoke in the first year of life was associated with lower lung function at age one.

The Drakenstein Child health study included 1 000 infants born in Paarl, followed from birth till the age of one. Infants had their lung function measured when they were diagnosed with pneumonia, and a month afterwards.

Researchers will monitor the infants through their childhood.

“We were able to develop reference lung-function data for African infants for the first time, which will be key for ongoing research in this area,” Gray said.

She said research from high-income countries has shown that lung disease in early life is associated with later lung disease, but despite the high incidence of lung disease in low to middle-income countries, this has not been assessed in these areas.

“Although these lung function measures are now commonly used in some high-income countries, they have not been used before in Africa, and not commonly used in large community cohorts such as this anywhere in the world.”

Gray said maternal health needs to be optimised, pneumonia prevention strategies strengthened, tobacco smoke and indoor air pollution exposure during pregnancy and early life reduced.

The hospital’s head of paediatrics and child health, Professor Heather Zar, said it was important to understand what determines respiratory health in early life in order to devise appropriate measures to prevent and manage it since most lung diseases have their origins in early life, and even before birth.

“(Respiratory disease) is still the number one killer of children in South Africa and Africa,” she said, adding that the study had shown that pneumonia was a major cause of childhood respiratory illness.

“Now we are appreciating how the long-term effects of pneumonia may result in chronic ill health,” she said. The research will lend itself to develop new strategies to prevent pneumonia.

1 000 infants born in Paarl to be monitored throughout childhood