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

    Research output: Contribution to journalArticle

    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 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.

    Original languageEnglish
    Article number213389
    Pages (from-to)28-37
    Number of pages10
    JournalThorax
    Volume75
    Issue number1
    Early online date2019
    DOIs
    Publication statusPublished - 13 Dec 2019

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  • Cite this

    Perret, J. L., Lodge, C. J., Lowe, A. J., Johns, D. P., Thompson, B. R., Bui, D. S., Gurrin, L. C., Matheson, M. C., McDonald, C. F., Wood-Baker, R., Svanes, C., Thomas, P. S., Giles, G. G., Chang, A. B., Abramson, M. J., Walters, E. H., & Dharmage, S. C. (2019). Childhood pneumonia, pleurisy and lung function: A cohort study from the first to sixth decade of life. Thorax, 75(1), 28-37. [213389]. https://doi.org/10.1136/thoraxjnl-2019-213389