RT Journal Article
SR Electronic
T1 Childhood ‘bronchitis’ and respiratory outcomes in middle-age: a prospective cohort study from age 7 to 53 years
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e001212
DO 10.1136/bmjresp-2022-001212
VO 9
IS 1
A1 Jennifer L Perret
A1 Danielle Wurzel
A1 E Haydn Walters
A1 Adrian J Lowe
A1 Caroline J Lodge
A1 Dinh S Bui
A1 Bircan Erbas
A1 Gayan Bowatte
A1 Melissa A Russell
A1 Bruce R Thompson
A1 Lyle Gurrin
A1 Paul S Thomas
A1 Garun Hamilton
A1 John L Hopper
A1 Michael J Abramson
A1 Anne B Chang
A1 Shyamali C Dharmage
YR 2022
UL http://bmjopenrespres.bmj.com/content/9/1/e001212.abstract
AB 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.Data are available on reasonable request. TAHS is a cohort study with data that has been prospectively collected since 1968 and will be an ongoing resource for future epidemiological analyses. Data collection protocols have been detailed in the TAHS cohort profile paper published in 2016 (Matheson et al. 2016 doi: 10.1093/ije/dyw028). The raw data have not been made widely available, but expressions of interest can be discussed with the corresponding author, JLP and/or principal investigator, SCD, on an individual basis.