Childhood risk factors increase adult COPD risk as much as heavy smoking

January 01, 0001

Childhood risk factors increase adult COPD risk as much as heavy smoking

These European and Australian researchers investigated the influence of early life development on adult respiratory function. European Community Respiratory Health Survey participants aged 20-45 years were randomly selected from general populations in 29 centres and has intial spirometry measurements (n=13,359) and again 9 years later (n=7738). Associations between early life factors and later FEV1 measurements and COPD were analysed with generalised estimating equation models and random effects linear models.

The authors found: "Maternal asthma, paternal asthma, childhood asthma, maternal smoking and childhood respiratory infections were significantly associated with lower FEV1 and defined as childhood disadvantage factors. Forty percent had one or more childhood disadvantage factors which were associated with lower FEV1 (men- adjusted difference 95 ml), women- adjusted difference 60 ml). FEV1 decreased with increasing number of childhood disadvantage factors (greater than or equal to 3 factors, men- 274 ml, women- 208 ml). Childhood disadvantage was associated with a larger FEV1 decline (1 factor- 2.0 ml per year, 2 factors- 3.8 ml, 3 or more factors- 2.2 ml). COPD increased with increasing childhood disadvantage (1 factor- men: OR 1.7, women: OR 1.6, 3 or more factors- men: OR 6.3, women: OR 7.2). These findings were consistent between centres and when subjects with asthma were excluded."

The authors concluded: "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."

This intriguing study suggests a high risk of adult COPD with several pediatric factors, including asthma, maternal smoking and respiratory infections, which demonstrates the importance of childhood environment and health to lifelong health.

For the full abstract, click here.

Thorax 65(1):14-20, January 2010 © 2009 BMJ Publishing Group Ltd and the British Thoracic Society
Early life origins of chronic obstructive pulmonary disease. C Svanes, J Sunyer, E Plana, et al. Correspondence to C Svanes: [email protected]

Category: R .Respiratory. Keywords: COPD, childhood asthma, parental asthma, maternal smoking, FEV1, epidemiologic study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 3 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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