[The paediatric roots of chronic obstructive pulmonary disease]

Early disturbances in pulmonary development seem to favour the occurrence of the functional impairments observed in COPD. In utero exposure to maternal smoking is the most commonly documented antenatal factor. Early life events such as the bronchopulmonary dysplasia are responsible for hypoalveolisation. The effects of passive smoking during childhood are prolonged into adulthood. The role of viral respiratory infections in early childhood remains a subject for debate. Finally the role of genes implied in pulmonary development both pre and post natally is beginning to be recognized. The decline of the respiratory function that occurs in adulthood leads then more rapidly to the functional criteria of COPD, particularly in the event of active smoking. There thus exist epidemiological and fundamental arguments, which support the idea that the COPD has at least, in part, a paediatric origin.