Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study
Open accessAbstract
Background Together with smoking, the lung function attained in early adulthood is one of the strongest predictors of chronic obstructive pulmonary disease. We aimed to investigate whether lung function in early adulthood is, in turn, affected by airway function measured shortly after birth. Methods Non-selected infants were enrolled at birth in the Tucson Children's Respiratory Study between 1980 and 1984. We measured maximal expiratory flows at functional residual capacity (Vmax(FRC)) in 169 of these infants by the chest compression technique at a mean of 2.3 months (SD 1.9). We also obtained measurements of lung function for 123 of these participants at least once at ages 11, 16, and 22 years. Indices were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of FVC (FEF25-75), both before and after treatment with a bronchodilator (180 microg of albuterol). Findings Participants who had infant Vmax(FRC) in the lowest quartile also had lower values for the FEV1/FVC ratio (-5.2%, p<0.0001), FEF25-75 (-663 mL/s, p<0.0001), and FEV1 (-233 mL, p=0.001) up to age 22, after adjustment for height, weight, age, and sex, than those in the upper three quartiles combined. The magnitude and significance of this effect did not change after additional adjustment for wheeze, smoking, atopy, or parental asthma. Interpretation Poor airway function shortly after birth should be recognised as a risk factor for airflow obstruction in young adults. Prevention of chronic obstructive pulmonary disease might need to start in fetal life.
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- Authors
- Stern, D. A., Morgan, W. J., Wright, A. L., Guerra, S., & Martinez, F. D.
- Affiliations
- University of Arizona (US)
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2007-09
- Volume
- 370
- Issue
- 9589
- Pages
- 758-764
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC2831283
- OpenAlex
- W2013981256
- Cited by
- 615
- References
- 3
- Citations by year
- 2026: 13 · 2025: 24 · 2024: 41 · 2023: 33 · 2022: 30 · 2021: 28 · 2020: 31 · 2019: 34 · 2018: 36 · 2017: 39 · 2016: 32 · 2015: 42 · 2014: 41 · 2013: 30 · 2012: 36
- FWCI
- 29.20
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p50hl014136-25)
- National Heart, Lung, and Blood Institute (HL-14136, R01HL056177, HL-56177)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- lung function, early adulthood, chronic obstructive pulmonary disease, airflow obstruction, maximal expiratory flow, functional residual capacity, forced expiratory volume, forced expiratory flow, bronchodilator response, salbutamol, childhood wheezing, atopy, parental asthma, smoking, Tucson Children's Respiratory Study
- MeSH terms
- Adolescent, Adult, Child, Female, Forced Expiratory Flow Rates, Humans, Infant, Longitudinal Studies, Male, Respiratory Tract Diseases, Time Factors, Pulmonary Disease, Chronic Obstructive
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