Early growth and adult respiratory function in men and women followed from the fetal period to adulthood

Abstract

Background: While some studies suggest that poor fetal growth rate, as indicated by lower birth weight, is associated with poor respiratory function in childhood, findings among adults remain inconsistent. A study was undertaken to determine the association between early growth and adult respiratory function. Methods: A longitudinal birth cohort study was performed of 5390 men and women born full term and prospectively followed from the fetal period to adulthood. Weight at birth and infancy were recorded, and forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) were assessed by standard spirometry at age 31 years. Results: Adult FEV 1 and FVC increased linearly with higher birth weight in both men and women with no apparent threshold. After adjustment for sex, adult height and other potential confounders operating through the life course, every 500 g higher birth weight was associated with a higher FEV 1 of 53.1 ml (95% CI 38.4 to 67.7) and higher FVC of 52.5 ml (95% CI 35.5 to 69.4). These positive associations persisted across categories of smoking, physical activity and body mass index, with the lowest respiratory function noted among those with lower birth weight who were smokers, led a sedentary lifestyle or were overweight. Weight gain in infancy was also positively associated with adult lung function. Conclusion: Birth weight is continuously and independently associated with adult respiratory function. It is plausible that poor growth in early life may restrict normal lung growth and development, which could have long-term consequences on lung function later in life.

Early growth characteristics and the risk of reduced lung function and asthma: A meta-analysis of 25,000 children

“…236 development of airways and alveoli occurs in early life (37). Developmental adaptations in 238 fetal life and infancy due to early life adverse exposures might result in impaired lung growth 239 with smaller airways, decreased lung volume, and subsequently to an increased risk of 240 bronchopulmonary dysplasia, asthma or COPD (9,14,38). Previous studies suggest that 241 children with asthma already have a reduced lung function in the first months of life, and that 242 this deficit progresses into childhood and early adulthood (39,40).…”

Birth Weight and Lung Function in Adulthood: A Systematic Review and Meta-analysis

“…All studies were in English and all 18 articles reported associations for FVC, while only 10 also reported FEV1/FVC. One article reported results from two different study populations (17) and five reported results for males and females separately (18)(19)(20)(21)(22), so the total number of comparisons was 24 for FVC and 14 for FEV1/FVC ( Figure E1). Birth weight was investigated in all 18 studies, whereas there was only one for weight at one year and another one for weight gain in the first year of life.…”

Age, Sexual Dimorphism, and Disease Associations in the Developing Human Fetal Lung Transcriptome

“…In utero exposures, such as smoking, have been shown to influence the developing fetal lung (1). Variations in lung maturity and in genes known to be expressed during lung development, and birth weight, have been associated with childhood asthma, bronchopulmonary dysplasia (BPD), adult lung function, and with death from chronic obstructive airways disease in adult life (2)(3)(4). This highlights the need to understand variability in the course of prenatal lung development, as it may contain the imprint for life-long pulmonary function growth/decline, and the developmental origins of chronic lung disease.…”