Childhood pneumonia, pleurisy and lung function: A cohort study from the first to sixth decade of life

Jennifer L. Perret, Caroline J. Lodge, Adrian J. Lowe, David P. Johns, Bruce R. Thompson, Dinh S. Bui, Lyle C. Gurrin, Melanie C. Matheson, Christine F. McDonald, Richard Wood-Baker, Cecilie Svanes, Paul S. Thomas, Graham G. Giles, Anne B. Chang, Michael J. Abramson, E. Haydn Walters, Shyamali C. Dharmage, on behalf of TAHS investigators

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Abstract

Introduction Adult spirometry following community-acquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctor-diagnosed childhood pneumonia/pleurisy and more comprehensive lung function in a middle-aged general population cohort born in 1961. Methods Data were from the prospective population-based Tasmanian Longitudinal Health Study cohort. Analysed lung function was from ages 7 years (prebronchodilator spirometry only, n=7097), 45 years (postbronchodilator spirometry, carbon monoxide transfer factor and static lung volumes, n=1220) and 53 years (postbronchodilator spirometry and transfer factor, n=2485). Parent-recalled histories of doctor-diagnosed childhood pneumonia and/or pleurisy were recorded at age 7. Multivariable linear and logistic regression were used. Results At age 7, compared with no episodes, childhood pneumonia/pleurisy-ever was associated with reduced FEV 1:FVC for only those with current asthma (beta-coefficient or change in z-score=-0.20 SD, 95% CI -0.38 to -0.02, p=0.028, p interaction=0.036). At age 45, for all participants, childhood pneumonia/pleurisy-ever was associated with a restrictive pattern: OR 3.02 (1.5 to 6.0), p=0.002 for spirometric restriction (FVC less than the lower limit of normal plus FEV 1:FVC greater than the lower limit of normal); total lung capacity z-score -0.26 SD (95% CI -0.38 to -0.13), p<0.001; functional residual capacity -0.16 SD (-0.34 to -0.08), p=0.001; and residual volume -0.18 SD (-0.31 to -0.05), p=0.008. Reduced lung volumes were accompanied by increased carbon monoxide transfer coefficient at both time points (z-score +0.29 SD (0.11 to 0.49), p=0.001 and +0.17 SD (0.04 to 0.29), p=0.008, respectively). Discussion For this community-based population, doctor-diagnosed childhood pneumonia and/or pleurisy were associated with obstructed lung function at age 7 for children who had current asthma symptoms, but with evidence of â € smaller lungs' when in middle age.

Original languageEnglish
Pages (from-to)28-37
Number of pages10
JournalThorax
Volume75
Issue number1
DOIs
Publication statusPublished - Jan 2020

Keywords

  • clinical epidemiology
  • respiratory infection

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