A. Greenough et al., FIRST-TRIMESTER INVASIVE PROCEDURES - EFFECTS ON SYMPTOM STATUS AND LUNG-VOLUME IN VERY YOUNG-CHILDREN, Pediatric pulmonology, 24(6), 1997, pp. 415-422
First trimester procedures have been associated with perinatal lung fu
nction abnormalities that may suggest subsequent respiratory problems.
Our aim was, therefore, to assess the impact of first trimester invas
ive procedures [early amniocentesis (EA) and chorion villus sampling (
CVS)I on respiratory morbidity in very young children. A questionnaire
was issued to parents of 439 EA and 453 CVS (subjects), and 435 contr
ols (their mothers had undergone no invasive procedures) when their ch
ildren were one year old. Data were also obtained from diary cards iss
ued to a subset of 278 of the EA, 262 of the CVS, and 264 of the contr
ol infants followed prospectively. Functional residual capacity (FRC)
was measured at a median age of 5 months (range: 0.25-24) in 159 child
ren whose mothers had undergone EA, 168 following CVS and in 165 contr
ols. Analysis of the one-year questionnaire demonstrated an excess of
symptomatic infants in the EA group (31%) compared to the CVS (22%; P
< 0.01) and control groups (17%; P < 0.01). Findings from the prospect
ive follow-up study confirmed those results and also demonstrated an i
ncrease in chest-related hospital admissions in the EA group (3%) comp
ared to the controls (0.4%; P < 0.05). Logistic regression analysis re
vealed that positive symptom status related significantly to EA and CV
S interventions (P < 0.0001), bottle feeding (P < 0.001), parental smo
king (P < 0.01), a family history of atopy (P < 0.01), and immaturity
(P < 0.01). In the control group, FRC correlated best with weight (r =
0.92). The mean FRC of the EA and CVS groups was higher than that of
the controls (P < 0.01). A higher proportion of children had an FRC tw
o standard deviations above the controls' mean in the EA group (n = 14
) compared to the CVS group (n = 3; P < 0.01). The symptomatic infants
tended to have higher FRCs than the asymptomatic children. We conclud
e that first trimester procedures are associated with increased respir
atory morbidity in Very young children. (C) 1997 Wiley-Liss, Inc.