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

Background and Objective: Despite 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. 

Methods: We 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. 

Results: Fifty-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). 

Conclusion: Young 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.