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Early life insults as determinants of chronic obstructive pulmonary disease in adult life

Authors Savran O, Ulrik CS

Received 9 October 2017

Accepted for publication 30 November 2017

Published 26 February 2018 Volume 2018:13 Pages 683—693


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Osman Savran,1 Charlotte Suppli Ulrik1,2

1Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark; 2Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

Background: Early life events may predispose to the development of chronic lung disease in adulthood.
Aim: To provide an update on current knowledge of early nongenetic origins of COPD.
Materials and methods: Systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results: A total of 16 studies, comprising 69,365 individuals, met the predefined criteria and were included in the present review. Studies have shown that in utero tobacco exposure, low birth weight, preterm birth, and respiratory diseases, primarily asthma and pneumonia, in early childhood are associated with lung function impairment later in childhood, and by that predispose to subsequent development of COPD, although the causal association between childhood respiratory diseases and COPD has been questioned in one study. Environmental tobacco exposure has also been shown to have negative impact on lung function in childhood possibly leading to COPD in adulthood, although it is at present not possible to clearly distinguish between the impact of active and the environmental tobacco exposure on subsequent development of COPD.
Conclusion: Tobacco exposure in utero and early life is a risk factor for subsequent development of COPD. Furthermore, low birth weight, lower respiratory tract infections and asthma, including wheezy bronchitis, in childhood also seem to be important determinants for later development of COPD. Early life insults may, therefore, be crucial to COPD development.

Keywords: COPD, respiratory infections, obstructive lung disease, preterm birth, tobacco exposure, early life, secondhand smoke

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