Abstract
BACKGROUND: Chronic bronchitis in childhood is associated with a diagnosis of asthma and/or bronchiectasis a few years later, however, consequences into middle-age are unknown. OBJECTIVE: To investigate the relationship between childhood bronchitis and respiratory-related health outcomes in middle-age. DESIGN: Cohort study from age 7 to 53 years. SETTING: General population of European descent from Tasmania, Australia. PARTICIPANTS: 3202 participants of the age 53-year follow-up (mean age 53, range 51-55) of the Tasmanian Longitudinal Health Study cohort who were born in 1961 and first investigated at age 7 were included in our analysis. STATISTICAL METHODS: Multivariable linear and logistic regression. The association between parent reported childhood bronchitis up to age 7 and age 53-year lung conditions (n=3202) and lung function (n=2379) were investigated. RESULTS: Among 3202 participants, 47.5% had one or more episodes of childhood bronchitis, classified according to severity based on the number of episodes and duration as: 'non-recurrent bronchitis' (28.1%); 'recurrent non-protracted bronchitis' (18.1%) and 'recurrent-protracted bronchitis' (1.3%). Age 53 prevalence of doctor-diagnosed asthma and pneumonia (p-trend <0.001) and chronic bronchitis (p-trend=0.07) increased in accordance with childhood bronchitis severities. At age 53, 'recurrent-protracted bronchitis' (the most severe subgroup in childhood) was associated with doctor-diagnosed current asthma (OR 4.54, 95% CI 2.31 to 8.91) doctor-diagnosed pneumonia (OR=2.18 (95% CI 1.00 to 4.74)) and, paradoxically, increased transfer factor for carbon monoxide (z-score +0.51 SD (0.15-0.88)), when compared with no childhood bronchitis. CONCLUSION: In this cohort born in 1961, one or more episodes of childhood bronchitis was a frequent occurrence. 'Recurrent-protracted bronchitis', while uncommon, was especially linked to multiple respiratory outcomes almost five decades later, including asthma, pneumonia and raised lung gas transfer. These findings provide insights into the natural history of childhood 'bronchitis' into middle-age.
| Original language | English |
|---|---|
| Article number | e001212 |
| Pages (from-to) | 1-11 |
| Number of pages | 11 |
| Journal | BMJ Open Respiratory Research |
| Volume | 9 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jun 2022 |
Bibliographical note
Funding Information:The TAHS was supported by the National Health and Medical Research Council (NHMRC) of Australia, research grants 299901 and 1021275; the University of Melbourne; Clifford Craig Foundation; the Victorian, Queensland and Tasmanian Asthma Foundations; Royal Hobart Hospital; Helen MacPherson Smith Trust; and GlaxoSmithKline. JP, AL, ABC and SCD are funded through the NHMRC of Australia. DW is funded by a fellowship from the NHMRC CRE in bronchiectasis (AusBREATHE). ABC is also supported by the Queensland Children’s Foundation.
Funding Information:
JP, AL, CL, DB, EHW, MJA and SCD have received an investigator-initiated grant from GlaxoSmithKline for unrelated research, and SCD holds a similar grant from AstraZeneca. MJA also holds investigator-initiated grants from Pfizer, Boehringer-Ingelheim and Sanofi for unrelated research; has undertaken an unrelated consultancy and received assistance with conference attendance from Sanofi; and received a speaker’s fee from GlaxoSmithKline. ABC is on independent data safety and monitoring boards for a SARs-COV2 vaccine (Moderna), an unlicensed RSV vaccine (GSK) and monoclonal antibody (AstraZeneca), where the monies are received by her institution. BRT serves on the medical advisory boards of Chiesi Australia and 4D Medical and has received an unrelated consultancy from GlaxoSmithKline and speaker fees from Mundipharma. AL has received investigational product (EpiCeram TM) free of charge from Primus Pharmaceuticals for use in unrelated research. DW has received consultancy fee from MSD for participation on an expert input forum, outside the submitted work.
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