Early-life exposures to smoking, infection, abuse up risk of COPD in adulthood

Childhood respiratory disease, maltreatment, maternal smoking, and low birth weight are all associated with an increased risk of chronic obstructive pulmonary disease (COPD) in adulthood, a study has found.

“Early life represents a critical period for the development and growth of the lungs,” the investigators said. “Adverse exposures in this stage may drive the development of COPD.”

In this systematic review and meta-analysis, articles published from January 2001 to October 2020 were searched using PubMed, Embase, and Cochrane Library electronic databases. Thirty studies including a total of 795,935 participants met the eligibility criteria and were included in the analysis.

COPD was found to significantly correlate with childhood serious respiratory infections, pneumonia, or bronchitis (pooled adjusted odds ratio [aOR], 2.23, 95 percent confidence interval [CI], 1.63–3.07). It was also more likely to develop among children with vs without asthma (pooled aOR, 3.45, 95 percent CI, 2.37–5.02).

Moreover, COPD development significantly correlated with maternal smoking (pooled aOR, 1.42, 95 percent CI, 1.17–1.72), any child maltreatment (pooled aOR, 1.30, 95 percent CI, 1.18–1.42), and low birth weight (pooled aOR, 1.58, 95 percent CI, 1.08–2.32), but not with childhood environmental tobacco smoke exposure (pooled aOR, 1.15, 95 percent CI, 0.83–1.61) or premature birth (pooled aOR, 1.17, 95 percent CI, 0.87–1.58).

In subgroup analysis, the increased risk of COPD was noted only in women with childhood physical abuse, sexual abuse, and exposure to intimate partner violence.

“Factors resulting in COPD in adults could trace back to early life,” the investigators said. “Promising advances in prevention strategies for early life exposures could markedly decrease the risk of COPD.”