Perret, JL and Lodge, CJ and Lowe, AJ and Johns, DP and Thompson, BR and Bui, DS and Gurrin, LC and Matheson, MC and McDonald, CF and Wood-Baker, R and Svanes, C and Thomas, PS and Giles, GG and Chang, AB and Abramson, MJ and Walters, EH and Dharmage, SC, On behalf of TAHS investigators, Childhood pneumonia, pleurisy and lung function: A cohort study from the first to sixth decade of life, Thorax, 75, (1) pp. 28-37. ISSN 0040-6376 (2020) [Refereed Article]
Copyright 2020 The Authors
Introduction: Adult spirometry following communityacquired childhood pneumonia has variably been reported as showing obstructive or non-obstructive deficits. We analysed associations between doctordiagnosed 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 FEV1 :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 FEV1 :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 ’smaller lungs’ when in middle age.
|Item Type:||Refereed Article|
|Keywords:||lung function, pneumonia|
|Research Division:||Health Sciences|
|Research Field:||Epidemiology not elsewhere classified|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Johns, DP (Associate Professor David Johns)|
|UTAS Author:||Wood-Baker, R (Professor Richard Wood-Baker)|
|UTAS Author:||Walters, EH (Professor Haydn Walters)|
|Funding Support:||National Health and Medical Research Council (299901)|
|Web of Science® Times Cited:||8|
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