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Childhood bronchitis' and respiratory outcomes in middle-age: a prospective cohort study from age 7 to 53 years

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posted on 2022-10-13, 04:15 authored by JL Perret, D Wurzel, E Haydn Walters, AJ Lowe, CJ Lodge, DS Bui, Bircan ErbasBircan Erbas, G Bowatte, MA Russell, BR Thompson, L Gurrin, PS Thomas, G Hamilton, JL Hopper, MJ Abramson, AB Chang, SC Dharmage
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.

Funding

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.

History

Publication Date

2022-06-20

Journal

BMJ Open Respiratory Research

Volume

9

Issue

1

Article Number

e001212

Pagination

11p.

Publisher

BMJ

ISSN

2052-4439

Rights Statement

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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