Associations between birth weight, early childhood weight gain and adult lung function

Abstract

Background: Low birth weight is associated with lower values for spirometry in adults but it is not known if birth weight influences other measures of pulmonary function. It is also unclear whether postnatal growth affects adult lung function. The associations between birth weight, postnatal growth and adult lung function were assessed in an unselected birth cohort of 1037 children. Methods: Birth weight, weight gain between birth and age 3 years, and lung function at age 32 years were measured. Analyses were adjusted for adult height and sex and further adjusted for multiple other potential confounding factors. Results: Birth weight was positively correlated with spirometric (forced expiratory volume in 1 s and forced vital capacity) and plethysmographic (total lung capacity and functional residual capacity) lung function and with lung diffusing capacity. These associations persisted after adjustment for confounding factors including adult weight, exposure to cigarette smoke in utero and during childhood, personal smoking, socioeconomic status, asthma and gestational age. Weight gain between birth and age 3 years was also positively associated with lung diffusing capacity, and with higher values of lung volumes in men after adjustment for covariates. Neither birth weight nor postnatal weight gain was associated with airflow obstruction. Conclusions: Low birth weight and lower weight gain in early childhood are associated with modest reductions in adult lung function across a broad range of measures of lung volumes and with lower diffusing capacity. These findings are independent of a number of potential confounding factors and support the hypothesis that fetal and infant growth is a determinant of adult lung function.

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).…”

Weight gain in the first two years of life, asthma and atopy: the SCAALA cohort study

“…Likewise, Lucas et al reported that when weight gain and pulmonary function were evaluated between 5 and 14 weeks of life, higher rates of weight gain were positively associated with impaired pulmonary function (10) . Nevertheless, in the study conducted by Hancox et al, weight gain in the first three years of life was positively associated with better pulmonary capacity (functional residual capacity) in young adults (9) . The mechanisms involved in the association between fast growth and impaired pulmonary function are not fully understood.…”

“…Studies conducted in different populations have shown an effect of weight gain during infancy on pulmonary function in early (10,25) or late (9) life. A prospective study conducted in Australia concluded that fast weight gain between the first and the twelfth months of life, particularly in children of low birth weight, was associated with decreased pulmonary function at 12 months and increased symptoms of transient asthma, suggesting an important association between somatic growth and pulmonary function in childhood (25) .…”

“…Few studies have evaluated the association between somatic growth in early childhood and asthma or lung function at school age or in adulthood (7)(8)(9)(24)(25)(26) . Fast growth in early childhood was associated with wheezing (7,24) in scholars.…”

“…Birth weight above 4500 g has been shown to be both a risk and a protective factor for the development of asthma in childhood (8) . There is evidence that in adults, poorer weight gain in the early years of life may be related to a slight decrease in pulmonary function, and lung volume and diffusing capacity increase by 2-4 % when birth weight increases by 30 % (9) . Nevertheless, at 5-14 weeks after birth, impairment in pulmonary function was found to be worse in infants whose postnatal weight gain was greater (highest tertile) (10) .…”