Study links respiratory illness in childhood to premature adult death

Key takeaways:

• People who had a lower respiratory tract infection in childhood were more likely to die from a respiratory disease in adulthood.
• The findings stood when adjusted for smoking factors and socioeconomic status as a child.

A decades-long study that enrolled participants in the 1940s found that contracting a lower respiratory tract infection in early childhood was associated with a higher risk for premature death from respiratory disease in adulthood.

“We've known for a long time that infant health impacts adult respiratory health, but there haven't been many opportunities to look at this longitudinally, with the same people being studied from birth to adulthood,” James P. Allinson, PhD, a senior clinical lecturer in the faculty of medicine at the National Heart and Lung Institute at Imperial College London, told Healio.

“We also didn't really know the national burden of this connection,” Allinson said. “Was the link responsible for a large number of deaths, or was it connected to a low number of deaths? It's really the opportunity to look at this within this unique cohort that was nationally representative.”

He explained that the main reason that early childhood is a “critically important developmental period” is that the alveoli, the air sacs at the end of bronchioles where lungs and blood exchange oxygen and carbon dioxide in the lungs, are still developing when an infant is born.

“[The alveoli] are continuing to bud over those first years,” Allinson said. “If you have something to disrupt it, that can have a lasting impact for the rest of your life.”

Allinson and colleagues used data from a British cohort study called the National Survey of Health and Development, which recruited individuals at birth in 1946, and studied participants’ health and death records until 2019.

Among 3,589 participants, 674 died prematurely — defined as before age 73 years. Among them, 52 died from an adult respiratory disease such as chronic obstructive pulmonary disease, interstitial lung disease, acute lower respiratory tract infection and respiratory disease due to external patients.

Of the total cohort, 913 participants had a lower respiratory tract infection — such as pneumonia, bronchitis or bronchopneumonia — before age 2 years. These participants had a greater risk for premature death from respiratory disease by age 73 years than those who did not have a lower respiratory tract infection in childhood (HR = 1.93; 95% CI, 1.10-3.37), even after adjusting for factors like socioeconomic position and smoking habits as an adult.

Allinson said the study emphasizes “how potentially vulnerable and important health is in early childhood.”

“To prevent the perpetuation of existing adult health inequalities, we need to optimize childhood health,” Allinson said in a release.

References:

Allinson JP, et al. Lancet. 2023;doi:10.1016/S0140-6736(23)00131-9.

Respiratory disease in early childhood linked to higher risk of death in adulthood https://www.eurekalert.org/news-releases/981919. Published March 7, 2023. Accessed March 16, 2023.