Association between perinatal and early life exposures and lung function in Australian Indigenous young adults: The Aboriginal Birth Cohort study

Author:

Navaratnam Vidya1234ORCID,Forrester Douglas L.1345ORCID,Chang Anne B.26ORCID,Dharmage Shyamali C.7ORCID,Singh Gurmeet R.2

Affiliation:

1. Department of Respiratory Medicine Sir Charles Gardiner Hospital Perth Western Australia Australia

2. Child Health Division, Menzies School of Health Research Charles Darwin University Darwin Northern Territory Australia

3. Faculty of Health Science Curtin University Perth Western Australia Australia

4. Centre for Respiratory Research University of Western Australia Perth Western Australia Australia

5. Department of Respiratory Medicine Royal Darwin Hospital Darwin Northern Territory Australia

6. Department of Respiratory Medicine Queensland Children's Hospital, Queensland University of Technology Brisbane Queensland Australia

7. Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health University of Melbourne Melbourne Victoria Australia

Abstract

AbstractBackground and ObjectiveDespite the high burden of respiratory disease amongst Indigenous populations, prevalence data on spirometric deficits and its determinants are limited. We estimated the prevalence of abnormal spirometry in young Indigenous adults and determined its relationship with perinatal and early life factors.MethodsWe used prospectively collected data from the Australian Aboriginal Birth Cohort, a birth cohort of 686 Indigenous Australian singletons. We calculated the proportion with abnormal spirometry (z‐score <−1.64) and FEV1 below the population mean (FEV1% predicted 0 to −2SD) measured in young adulthood. We evaluated the association between perinatal and early life exposures with spirometry indices using linear regression.ResultsFifty‐nine people (39.9%, 95%CI 31.9, 48.2) had abnormal spirometry; 72 (49.3%, 95%CI 40.9, 57.7) had a FEV1 below the population mean. Pre‐school hospitalisations for respiratory infections, younger maternal age, being overweight in early childhood and being born remotely were associated with reduced FEV1 and FVC (absolute, %predicted and z‐score). The association between maternal age and FEV1 and FVC were stronger in women, as was hospitalization for respiratory infections before age 5. Being born remotely had a stronger association with reduced FEV1 and FVC in men. Participants born in a remote community were over 6 times more likely to have a FEV1 below the population mean (odds ratio [OR] 6.30, 95%CI 1.93, 20.59).ConclusionYoung Indigenous adults have a high prevalence of impaired lung function associated with several perinatal and early life factors, some of which are modifiable with feasible interventions.

Funder

National Health and Medical Research Council

National Institute for Health Research Applied Research Collaboration South London

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine

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