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Childhood pneumonia, pleurisy and lung function: A cohort study from the first to sixth decade of life
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:||13|
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