Early life origins of chronic obstructive pulmonary disease
Open accessAbstract
BACKGROUND: Early life development may influence subsequent respiratory morbidity. The impact of factors determined in childhood on adult lung function, decline in lung function and chronic obstructive pulmonary disease (COPD) was investigated. METHODS: European Community Respiratory Health Survey participants aged 20-45 years randomly selected from general populations in 29 centres underwent spirometry in 1991-3 (n = 13 359) and 9 years later (n = 7738). Associations of early life factors with adult forced expiratory volume in 1 s (FEV(1)), FEV(1) decline and COPD (FEV(1)/FVC ratio <70% and FEV(1) <80% predicted) were analysed with generalised estimating equation models and random effects linear models. RESULTS: Maternal asthma, paternal asthma, childhood asthma, maternal smoking and childhood respiratory infections were significantly associated with lower FEV(1) and defined as "childhood disadvantage factors"; 40% had one or more childhood disadvantage factors which were associated with lower FEV(1) (men: adjusted difference 95 ml (95% CI 67 to 124); women: adjusted difference 60 ml (95% CI 40 to 80)). FEV(1) decreased with increasing number of childhood disadvantage factors (> or =3 factors, men: 274 ml (95% CI 154 to 395), women: 208 ml (95% CI 124 to 292)). Childhood disadvantage was associated with a larger FEV(1) decline (1 factor: 2.0 ml (95% CI 0.4 to 3.6) per year; 2 factors: 3.8 ml (95% CI 1.0 to 6.6); > or =3 factors: 2.2 ml (95% CI -4.8 to 9.2)). COPD increased with increasing childhood disadvantage (1 factor, men: OR 1.7 (95% CI 1.1 to 2.6), women: OR 1.6 (95% CI 1.01 to 2.6); > or =3 factors, men: OR 6.3 (95% CI 2.4 to 17), women: OR 7.2 (95% CI 2.8 to 19)). These findings were consistent between centres and when subjects with asthma were excluded. CONCLUSIONS: People with early life disadvantage have permanently lower lung function, no catch-up with age but a slightly larger decline in lung function and a substantially increased COPD risk. The impact of childhood disadvantage was as large as that of heavy smoking. Increased focus on the early life environment may contribute to the prevention of COPD.
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The association in the retrospective study may be related to recall bias.
“While a number of studies have reported that childhood asthma itself has no impact on adult lung function decline (154, 157, 158, 160), a study that collected childhood asthma status retrospectively has reported that it is associated with greater lung function decline, which may be related to recall bias (161).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [161]
A study that collected childhood asthma status retrospectively reported that it is associated with greater lung function decline.
“While a number of studies have reported that childhood asthma itself has no impact on adult lung function decline (154, 157, 158, 160), a study that collected childhood asthma status retrospectively has reported that it is associated with greater lung function decline, which may be related to recall bias (161).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [161]
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- Authors
- Svanes, C., Sunyer, J., Plana, E., Dharmage, S., Heinrich, J., Jarvis, D., de Marco, R., Norback, D., Raherison, C., Villani, S., Wjst, M., Svanes, K., & Anto, J. M.
- Affiliations
- Haukeland University Hospital (NO)
- Universitat Pompeu Fabra (ES)
- Center for Research in Environmental Epidemiology (ES)
- The University of Melbourne (AU)
- Helmholtz Munich (DE)
- Imperial College London (GB)
- University of Pavia (IT)
- Corresponding author
- Svanes, C
- Svanes, K
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2009-09-02
- Volume
- 65
- Issue
- 1
- Pages
- 14-20
- ISSN
- 0040-6376 (ISSN-L)
- OpenAlex
- W2133281088
- Cited by
- 466
- References
- 51
- Citations by year
- 2026: 10 · 2025: 13 · 2024: 28 · 2023: 23 · 2022: 24 · 2021: 29 · 2020: 30 · 2019: 23 · 2018: 37 · 2017: 45 · 2016: 45 · 2015: 34 · 2014: 29 · 2013: 25 · 2012: 21
- FWCI
- 19.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Thorax (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Site cant be reached (submittedVersion)
- 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 › Physiology › Smoking Behavior and Cessation
- Keywords
- chronic obstructive pulmonary disease, early life factors, childhood disadvantage, lung function, FEV1 decline, maternal asthma, childhood asthma, maternal smoking, pediatric respiratory infection, childhood asthma risk factors, adult lung function, COPD risk factors, sex differences, European Community Respiratory Health Survey, spirometry, birth cohort comparison
- MeSH terms
- Adult, Asthma, Epidemiologic Methods, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Smoking, Vital Capacity, Age of Onset, Pulmonary Disease, Chronic Obstructive, Young Adult
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