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Published on: August 7, 2017
Childhood 'bronchitis' and respiratory outcomes in middle-age: a prospective cohort study from age 7 to 53 years
Jennifer L Perret1,2,3, Danielle Wurzel4,5,6, E Haydn Walters4,7
1Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia jennifer.perret@unimelb.edu.au.
Insights
Childhood bronchitis, particularly recurrent-protracted cases, is linked to adult respiratory issues like asthma and pneumonia decades later. This study tracked individuals from age 7 to 53, revealing long-term health consequences of early respiratory infections.
Area of Science:
- Respiratory Medicine
- Longitudinal Cohort Studies
- Pediatric Health
Background:
- Childhood chronic bronchitis is a known precursor to asthma and bronchiectasis.
- Long-term respiratory health consequences into middle-age remain largely unknown.
Purpose of the Study:
- To investigate the association between childhood bronchitis and respiratory health outcomes in middle-age.
- To understand the natural history of childhood bronchitis into adulthood.
Main Methods:
- Longitudinal cohort study of European descent participants from Tasmania, Australia.
- Analysis of parent-reported childhood bronchitis (up to age 7) and respiratory health at age 53.
- Multivariable regression models used to assess associations between childhood bronchitis severity and middle-age lung conditions and function.
Main Results:
- Nearly half of participants experienced childhood bronchitis, categorized by severity.
- Increased severity of childhood bronchitis correlated with higher prevalence of doctor-diagnosed asthma, pneumonia, and chronic bronchitis at age 53.
- Recurrent-protracted childhood bronchitis was significantly associated with current asthma, pneumonia, and paradoxically, increased lung gas transfer factor in middle-age.
Conclusions:
- Childhood bronchitis is common and has lasting respiratory impacts into middle-age.
- Severe childhood bronchitis, specifically recurrent-protracted cases, is a strong predictor of adult respiratory conditions.
- Findings offer crucial insights into the long-term trajectory of childhood respiratory health.
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.
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