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

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 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.

[1]  R. Hancox.  When is a confounder not a confounder? , 2018, Respirology.

[2]  G. Ogg,et al.  Fevipiprant inhibits prostaglandin D2 mediated activation of group 2 innate lymphoid cells (ILC2s) , 2018, Airway pharmacology and treatment.

[3]  P. Frith,et al.  Childhood Respiratory Risk Factor Profiles and Middle‐Age Lung Function: A Prospective Cohort Study from the First to Sixth Decade , 2018, Annals of the American Thoracic Society.

[4]  R. Wood‐Baker,et al.  Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life. , 2018, The Lancet. Respiratory medicine.

[5]  S. Stanojevic,et al.  Official ERS technical standards: Global Lung Function Initiative reference values for the carbon monoxide transfer factor for Caucasians , 2017, European Respiratory Journal.

[6]  D. Jarvis,et al.  Childhood Lung Function Predicts Adult Chronic Obstructive Pulmonary Disease and Asthma‐Chronic Obstructive Pulmonary Disease Overlap Syndrome , 2017, American journal of respiratory and critical care medicine.

[7]  Dan J Stein,et al.  Lung Function in African Infants in the Drakenstein Child Health Study. Impact of Lower Respiratory Tract Illness , 2017, American journal of respiratory and critical care medicine.

[8]  R. Wood‐Baker,et al.  Cohort profile Cohort Profile : The Tasmanian Longitudinal Health STUDY ( TAHS ) , 2017 .

[9]  Tyler J VanderWeele,et al.  Explanation in causal inference: developments in mediation and interaction. , 2016, International journal of epidemiology.

[10]  F. Martinez.  Early-Life Origins of Chronic Obstructive Pulmonary Disease. , 2016, The New England journal of medicine.

[11]  Paul D. Thomas,et al.  Mother's smoking and complex lung function of offspring in middle age: A cohort study from childhood , 2016, Respirology.

[12]  W. Self,et al.  Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. , 2015, The New England journal of medicine.

[13]  J. Soriano,et al.  Lung-Function Trajectories Leading to Chronic Obstructive Pulmonary Disease. , 2015, The New England journal of medicine.

[14]  S. Rennard,et al.  Early chronic obstructive pulmonary disease: definition, assessment, and prevention , 2015, The Lancet.

[15]  S. Guerra,et al.  Pneumonia in Childhood and Impaired Lung Function in Adults: A Longitudinal Study , 2015, Pediatrics.

[16]  Tyler J. VanderWeele,et al.  Explanation in Causal Inference: Methods for Mediation and Interaction , 2015 .

[17]  Anami R Patel,et al.  Community-acquired pneumonia requiring hospitalization among U.S. children. , 2015, The New England journal of medicine.

[18]  R. Wood‐Baker,et al.  The interplay between the effects of lifetime asthma, smoking, and atopy on fixed airflow obstruction in middle age. , 2013, American journal of respiratory and critical care medicine.

[19]  D. Johns,et al.  Childhood infections and the risk of asthma: a longitudinal study over 37 years. , 2012, Chest.

[20]  S. Stanojevic,et al.  Multi-ethnic reference values for spirometry for the 3–95-yr age range: the global lung function 2012 equations , 2012, European Respiratory Journal.

[21]  I. Rudan,et al.  Long Term Sequelae from Childhood Pneumonia; Systematic Review and Meta-Analysis , 2012, PloS one.

[22]  Dustin Tingley,et al.  Causal Mediation Analysis , 2011 .

[23]  N. Soto-Ramírez,et al.  Breastfeeding is associated with increased lung function at 18 years of age: a cohort study , 2011, European Respiratory Journal.

[24]  D. Jarvis,et al.  Early life origins of chronic obstructive pulmonary disease , 2009, Thorax.

[25]  M. Ezzati,et al.  Acute lower respiratory infections in childhood: opportunities for reducing the global burden through nutritional interventions. , 2008, Bulletin of the World Health Organization.

[26]  G. Giles,et al.  Tracing 8,600 participants 36 years after recruitment at age seven for the Tasmanian Asthma Study , 2006, Australian and New Zealand journal of public health.

[27]  J. Hankinson,et al.  Standardisation of the single-breath determination of carbon monoxide uptake in the lung , 2005, European Respiratory Journal.

[28]  G. Viegi,et al.  Standardisation of the measurement of lung volumes , 2005, European Respiratory Journal.

[29]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[30]  M. King.  Asthma after childhood pneumonia: six year follow up study , 2000, BMJ : British Medical Journal.

[31]  I. D. Johnston.  Effect of pneumonia in childhood on adult lung function. , 1999, The Journal of pediatrics.

[32]  J. Sterne,et al.  Birth weight, childhood lower respiratory tract infection, and adult lung function , 1998, Thorax.

[33]  I. D. Johnston,et al.  Effect of pneumonia and whooping cough in childhood on adult lung function. , 1998, The New England journal of medicine.

[34]  S. Holgate,et al.  The relationship between pneumonia in early childhood and impaired lung function in late adult life. , 1994, American journal of respiratory and critical care medicine.

[35]  J E Cotes,et al.  Lung volumes and forced ventilatory flows , 1993, European Respiratory Journal.

[36]  J E Cotes,et al.  Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. , 1993, The European respiratory journal. Supplement.

[37]  K. Godfrey,et al.  Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease. , 1991, BMJ.

[38]  J. Cuzick,et al.  A Wilcoxon-type test for trend. , 1985, Statistics in medicine.

[39]  O. Gsell.  The History of Pneumonia , 1952, Sudhoffs Archiv.

[40]  H. Simpson,et al.  Outcome of acute lower respiratory tract infection in infants: preliminary report of seven-year follow-up study. , 1982, British medical journal.

[41]  E. Hey,et al.  Wheezing, asthma, and pulmonary dysfunction 10 years after infection with respiratory syncytial virus in infancy. , 1982, British medical journal.

[42]  S. Leeder,et al.  Doctor diagnosis and maternal recall of lower respiratory illness. , 1982, International journal of epidemiology.

[43]  B. Gandevia,et al.  RESPIRATORY DISORDERS IN SEVEN‐YEAR‐OLD CHILDREN IN TASMANIA AIMS, METHODS AND ADMINISTRATION OF THE SURVEY , 1969, The Medical journal of Australia.