FIRST-TRIMESTER INVASIVE PROCEDURES - EFFECTS ON SYMPTOM STATUS AND LUNG-VOLUME IN VERY YOUNG-CHILDREN

Citation
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
Citations number
30
Journal title
ISSN journal
87556863
Volume
24
Issue
6
Year of publication
1997
Pages
415 - 422
Database
ISI
SICI code
8755-6863(1997)24:6<415:FIP-EO>2.0.ZU;2-2
Abstract
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.