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Table 1 Prospective birth cohort studies examining the effects of childhood pneumonia upon adult lung function

From: Long-term effects of pneumonia in young children

Study Country Year(s) of inception Year(s) of study Source of diagnosis No. with pneumonia No. with pneumonia studied (%) No. without pneumonia studied Ages (years) Median follow-up (years) Main findings
Barker et al. [23]a UK 1920–30 1989 Health visitors prospective reports of illness in the first yr, and between 1 and 5 yrs of life 122b 122 (100) 703 59–67 60 Bronchitis or pneumonia in male infants was associated with significantly reduced adult values for FEV1 (−0.17 L; 95% CI −0.32, −0.02) and FVC (−0.24 L; 95% CI −0.24, −0.07) and increased odds of wheezing (OR 1.83 [95% CI 1.05, 3.20]) independent of smoking, birth weight and social class.
Shaheen et al. [24]a UK 1921–35 1985–86 Doctors’ records for the first 5 yrs of life 18 10 (53) 229 57.6 ± 4.3d 50 Pneumonia in the first 2 yrs of life was associated with significantly reduced adult values for FEV1 (−0.39 L; 95% CI −0.67, −0.11; p = 0.007) and FVC (−0.60 L; 95% CI −0.92, −0.28); p < 0.001) independent of age, sex, height, smoking and other illnesses before age 2 yrs.
Johnston et al. [25]a UK 1958 1992–93 Parents report when child aged 7 yrs 350 193 (55) 1,199 34–35 30 History of pneumonia in the first 7 yrs of life was significantly associated with reduced adult FEV1 (−0.102 L; 95% CI −0.175, −0.029; p = 0.006) and FVC (−0.173 L; 95% CI −0.243, −0.067; p = 0.001) without a change in FEV1/FVC ratios, which were unaltered by bronchodilators and were independent of a history of wheezing.
Shaheen et al. [26] UK 1917–22 1990–91 Health visitors’ reports of illness collected 3 monthly in first yr, then once yearly 20 20 (100) 598 67–74 70 In men only, pneumonia before age 2 yrs was significantly associated with lower adult FEV1 (−0.65 L; 95% CI −1.02, −0.29, p < 0.001), FVC (−0.51 L; 95% CI −0.94, −0.08; p = 0.02) and FEV1/FVC ratios (−10.9%; 95% CI −16.9, −4.8; p < 0.001) independent of smoking and asthma.
Chan et al. [27] USA 1980–84 1996–2003 Clinical with CXR (infiltrates, bronchopneumonia or pneumonia) in the first 3 yrs of life 66 44 (67) 308 26–29 26 Those with pneumonia before 3 yrs of age had significantly lower FEV1/FVC ratios (−3.23%; p = 0.034)), FEF25-75 (−0.508 L/s; p = 0.02) and FEF25-75/FVC ratios (−11.14%; p = 0.024) at 26 yrs of age, independent of wheeze and smoking, and which were only partially reversible with bronchodilators. Pneumonia was also associated with a two-fold increased risk of actively managed asthma at age 29 yrs (OR 1.95 [95%CI 1.11, 3.44]; p = 0.02).
Lopez-Bernal et al. [28] UK 1972–74 1997 Study team or maternal report of respiratory illness in the first 5 yrs of lifec NR NR NR 25.0 ± 0.7d 25 679 (71%) of original cohort underwent lung function testing. After adjusting for potential confounding factors, lower respiratory tract infections in the first yr of life were negatively associated with all spirometry values, except for FVC, and showed a significant dose-response effect where a two-fold increase in lower respiratory tract infections was associated with reduced FEV1 (−0.078 L; 95% CI −0.153, −0.03), and FEV1/FVC ratios (−1.23%; 95% CI −2.22, −0.25).
Colley et al. [29] UK 1946 1966 Parent questioned when child aged 2 yrs (pneumonia, bronchopneumonia or bronchitis) 820 820 (100) 2,502 20e 20 In ‘never smokers’, prevalence of day/night cough was 9.1% in group with chest infections vs 5.2% without. In smokers, values were 16.5% and 13.5%, respectively. Difference between groups (with and without chest infections) was significant (p < 0.025). Social class and air pollution had no significant effect.
  1. CI, confidence interval; CXR, chest radiograph; FEV1, forced expiratory volume in one second; FVC, forced vital capacity; FEF25-75, forced expiratory flow between 25% and 75% of FVC; NR, not reported; OR, odds ratio; UK, United Kingdom; USA, United States of America
  2. aIncluded in review by Edmonds et al. [18]
  3. bMales only
  4. cSupplemented by a doctor’s diagnosis when available
  5. dMean ± Standard Deviation
  6. eCohort was born in the last week in March 1946. In 1966, they were all sent a questionnaire at the same time