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Outcomes of Childhood Asthma and Wheezy Bronchitis. A 50-Year Cohort Study
Nara Tagiyeva1, Graham Devereux1, Shona Fielding1
11 Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom; and.
Insights
Childhood asthma and wheezy bronchitis significantly increase the risk of developing chronic obstructive pulmonary disease (COPD) later in life. These early respiratory conditions are linked to reduced lung function by age 60.
Area of Science:
- Respiratory Medicine
- Epidemiology
- Pulmonology
Background:
- Childhood asthma is linked to later chronic obstructive pulmonary disease (COPD).
- The association between childhood wheezy bronchitis and COPD remains unclear.
- Early-life airflow obstruction can persist into adulthood.
Purpose of the Study:
- To determine if childhood wheezy bronchitis elevates COPD risk in individuals aged 60-65.
- To investigate the long-term respiratory health outcomes of childhood wheezing phenotypes.
Main Methods:
- A longitudinal cohort study followed individuals from childhood (age 10-15) to early old age (60-65).
- Spirometry (FEV1, FVC) was used to assess lung function.
- Time-to-event and mixed-effects models analyzed the association between childhood wheeze and COPD development.
Main Results:
- Childhood asthma (OR 6.37) and wheezy bronchitis (OR 1.81) were associated with increased COPD risk.
- Childhood wheezy bronchitis correlated with reduced FEV1 by the fifth decade.
- Adulthood-onset wheeze was linked to an accelerated rate of FEV1 decline.
Conclusions:
- Childhood wheezy bronchitis and asthma are significant risk factors for developing COPD.
- These early respiratory conditions contribute to reduced ventilatory function in later life.
Rationale:
Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD.
Objectives:
To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade.
Methods:
A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used.
Measurements And Main Results:
FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73-10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12-2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline.
Conclusions:
Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function.
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