ArticleLancet (London, England)2023
Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study.
Article in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 161 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
161 citing papers in PubMed, 4 syntheses or guidelines pooled it, 219 citations in OpenAlex.
- Factors associated with wheezing in Indigenous children and adolescents: A systematic review of the global literature.PloS one · 2026Pooled it
- The association between early-life respiratory infections and childhood asthma: a meta-analytic perspective.Frontiers in medicine · 2026Pooled it
- Association between age of respiratory syncytial virus infection hospitalization and childhood asthma: A systematic review.PloS one · 2024Pooled it
- Use of the Pfizer Respiratory Syncytial Virus Vaccine During Pregnancy for the Prevention of Respiratory Syncytial Virus-Associated Lower Respiratory Tract Disease in Infants: Recommendations of the Advisory Committee on Immunization Practices - United States, 2023.MMWR. Morbidity and mortality weekly report · 2023Guideline
- A Phase 1b/2a Trial of a Half-life Extended Respiratory Syncytial Virus Neutralizing Antibody, Clesrovimab, in Healthy Preterm and Full-term Infants.The Journal of infectious diseases · 2025Trial
- Infant respiratory syncytial virus and childhood asthma: a nationwide registry-based, sibling-controlled, and genome-wide association study.The Lancet regional health. Europe · 2026Article
- PIWIL4 regulates gene expression and piRNA levels in RSV-infected airway epithelial cells.iScience · 2026Article
- Article
- Exploring the Relationship Between Respiratory Syncytial Virus and Asthma Using Calendar Time at Birth as a Source of Quasi-Random Variation.Paediatric and perinatal epidemiology · 2026Article
- Early-life immune imprinting by a B. infantis-HMO synbiotic shapes infant immune signatures and protects against experimental respiratory disease.Cell reports. Medicine · 2026Article
- Mechanisms and therapeutic strategies of asthma: from bench to bedside.Signal transduction and targeted therapy · 2026Review
- Infant Infection With Respiratory Syncytial Virus Genotypes and Subsequent Childhood Asthma Risk.The Journal of infectious diseases · 2026Article
- Implications of RNA virus persistence for post-acute sequelae and chronic inflammatory syndromes.Nature immunology · 2026Review
- Perinatal and Parental Predictors of Wheezing in the First Year of Life: A Saudi Arabian Birth Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Diagnostic Value of Oxidative Stress-Related Features Mined by WGCNA and Machine Learning in Respiratory Syncytial Virus Infection.Advanced biology · 2026Article
- Protecting infants from RSV: cost-effectiveness of nirsevimab in a real-world study from Chile.Lancet regional health. Americas · 2026Article
- Asthma-related Pediatric Healthcare Utilization after Hospitalization for RSV and Other Viral Lower Respiratory Tract Infections.Open forum infectious diseases · 2026Article
- Reconstructing the post-pandemic landscape: a retrospective, hospital-based surveillance of respiratory pathogens in hospitalized children in Chenzhou, China, 2021-2025.BMC infectious diseases · 2026Article
- Catching our breath: development of interventions and therapies for respiratory syncytial virus.Microbiology and molecular biology reviews : MMBR · 2026Review
- TheBMJ open respiratory research · 2026Observational
101 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundEarly-life severe respiratory syncytial virus (RSV) infection has been associated with the onset of childhood wheezing illnesses. However, the relationship between RSV infection during infancy and the development of childhood asthma is unclear. We aimed to assess the association between RSV infection during infancy and childhood asthma.
methodsINSPIRE is a large, population-based, birth cohort of healthy infants with non-low birthweight born at term between June and December, 2012, or between June and December, 2013. Infants were recruited from 11 paediatric practices across middle Tennessee, USA. We ascertained RSV infection status (no infection vs infection) in the first year of life using a combination of passive and active surveillance with viral identification through molecular and serological techniques. Children were then followed up prospectively for the primary outcome of 5-year current asthma, which we analysed in all participants who completed 5-year follow-up. Statistical models, which were done for children with available data, were adjusted for child's sex, race and ethnicity, any breastfeeding, day-care attendance during infancy, exposure to second-hand smoke in utero or during early infancy, and maternal asthma.
findingsOf 1946 eligible children who were enrolled in the study, 1741 (89%) had available data to assess RSV infection status in the first year of life. The proportion of children with RSV infection during infancy was 944 (54%; 95% CI 52-57) of 1741 children. The proportion of children with 5-year current asthma was lower among those without RSV infection during infancy (91 [16%] of 587) than those with RSV infection during infancy (139 [21%] of 670; p=0·016). Not being infected with RSV during infancy was associated with a 26% lower risk of 5-year current asthma than being infected with RSV during infancy (adjusted RR 0·74, 95% CI 0·58-0·94, p=0·014). The estimated proportion of 5-year current asthma cases that could be prevented by avoiding RSV infection during infancy was 15% (95% CI 2·2-26·8).
interpretationAmong healthy children born at term, not being infected with RSV in the first year of life was associated with a substantially reduced risk of developing childhood asthma. Our findings show an age-dependent association between RSV infection during infancy and childhood asthma. However, to definitively establish causality, the effect of interventions that prevent, delay, or decrease the severity of the initial RSV infection on childhood asthma will need to be studied.
fundingUS National Institutes of Health.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.