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Early life exposures contributing to accelerated lung function decline in adulthood: a follow-up study of 11,000 adults from the general population
Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Dermatology, Medical University of Vienna, Vienna, Austria.
Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
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2023 (English)In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 66, article id 102339Article in journal (Refereed) Published
Abstract [en]

Background: We aimed to assess whether exposure to risk factors in early life from conception to puberty continue to contribute to lung function decline later in life by using a pooled cohort comprising approx. 11,000 adults followed for more than 20 years and with up to three lung function measurements.

Methods: Participants (20–68 years) in the ECRHS and NFBC1966 cohort studies followed in the periods 1991–2013 and 1997–2013, respectively, were included. Mean annual decline in maximum forced expired volume in 1 s (FEV1) and forced vital capacity (FVC) were main outcomes. Associations between early life risk factors and change in lung function were estimated using mixed effects linear models adjusted for sex, age, FEV1, FVC and height at baseline, accounting for personal smoking.

Findings: Decline in lung function was accelerated in participants with mothers that smoked during pregnancy (FEV1 2.3 ml/year; 95% CI: 0.7, 3.8) (FVC 2.2 ml/year; 0.2, 4.2), with asthmatic mothers (FEV1 2.6 ml/year; 0.9, 4.4) (FEV1/FVC 0.04 per year; 0.04, 0.7) and asthmatic fathers (FVC 2.7 ml/year; 0.5, 5.0), and in women with early menarche (FVC 2.4 ml/year; 0.4, 4.4). Personal smoking of 10 pack-years contributed to a decline of 2.1 ml/year for FEV1 (1.8, 2.4) and 1.7 ml/year for FVC (1.3, 2.1). Severe respiratory infections in early childhood were associated with accelerated decline among ever-smokers. No effect-modification by personal smoking, asthma symptoms, sex or cohort was found.

Interpretation: Mothers’ smoking during pregnancy, parental asthma and early menarche may contribute to a decline of FEV1 and FVC later in life comparable to smoking 10 pack-years. 

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 66, article id 102339
Keywords [en]
Accelerated decline, Early life risk factors, FEV1, FEV1/FVC ratio, FVC, Lung function, Maternal asthma, Maternal smoking, Paternal asthma
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:umu:diva-218319DOI: 10.1016/j.eclinm.2023.102339Scopus ID: 2-s2.0-85179447237OAI: oai:DiVA.org:umu-218319DiVA, id: diva2:1821822
Funder
EU, Horizon 2020, 633212EU, Horizon 2020, 874703The Research Council of Norway, 274767Academy of Finland, 285547European Regional Development Fund (ERDF), 539/2010 A31592EU, Horizon 2020, 633212EU, Horizon 2020, 824989Available from: 2023-12-21 Created: 2023-12-21 Last updated: 2024-02-08Bibliographically approved

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Franklin, Karl A.

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