Prevention Of COPD May Need To Start In Fetal Life

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Main Category: COPD
Also Included In: Pediatrics / Children's Health
Article Date: 01 Sep 2007 - 0:00 PDT

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COPD prevention should commence before birth, as poor airway function soon after birth is a known risk factor for airflow obstruction during early adulthood, according to an article in the latest issue of The Lancet.

Professor Fernando Martinez, Arizona Respiratory Centre, University of Arizona Health Sciences Center, Tucson, Arizona, USA and team carried out a study on 169 babies who were enrolled at birth in the Tucson Children's Respiratory Study during the period 1980-1883. Each baby had his/her maximum expiratory airflows measured using the chest compression technique at the age of 2.3 months. 123 of the babies had further lung function tests carried out when they were 11, 16 and 22 years old. The following measurements were taken:

-- forced expiratory volume in one second (FEV1)
-- forced vital capacity (FVC)
-- forced expiratory flow between 25% and 75% of FVC (FEF25-75)*, both before and after treatment with a bronchodilator (180 μg albuterol)

The scientists found that those in the bottom 25% for maximum expiratory flows when they were babies had inferior values for FEV1, FVC, and FEF25-75 when they were 22 years old, compared to the top 25%. Adjustments were made for age, sex, height and weight. Even after further adjustments were made for wheeze, atopy, parental asthma and/or smoking the differences remained the same.

The writers concluded that those born with inferior lung function tend to continue this trend well into early adulthood. They said further research would tell us how the lungs develop in the fetus. It is possible that the process is being impaired in utero by either genetic or environmental factors, or both. Previous studies have linked poor lung function in infants and older children to maternal smoking.

The authors wrote "Our results suggest that a better understanding of the mechanisms that control normal lung growth in utero would contribute to development of strategies for the prevention of COPD in adult life."

Professor Michael Silverman, University of Leicester, UK, and Dr Claudia Kuehni, University of Bern, Switzerland, in an accompanying Comment, wrote: "As COPD is set globally to become the third most important cause of death, now is the time to add research into its earliest origins to the agenda."

"Poor airway function in early infancy and lung function by age 22 years: a non-selective longitudinal cohort study"
Debra A Stern, Prof Wayne J Morgan MD, Anne L Wright PhD, Stefano Guerra MD and Prof Fernando D Martinez MD
The Lancet 2007; 370:758-764 DOI:10.1016/S0140-6736(07)61379-8
Click here to view abstract online (log in required)

Written by: Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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