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Asthma-like symptoms in young children increase the risk of COPD
Hans Bisgaard1, Sarah Nørgaard1, Astrid Sevelsted1
1Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Insights
Childhood asthma-like symptoms significantly increase the risk of developing chronic obstructive pulmonary disease (COPD) later in life. This 60-year study found a doubled COPD risk in adults with early childhood respiratory symptoms.
Area of Science:
- Pulmonary Medicine
- Epidemiology
- Longitudinal Cohort Studies
Background:
- Chronic obstructive pulmonary disease (COPD) origins in early life and shared mechanisms with childhood asthma remain understudied.
- Lack of long-term prospective studies hinders understanding of the link between early respiratory symptoms and adult COPD.
Purpose of the Study:
- To investigate the association between asthma-like symptoms in early childhood and the subsequent development of COPD.
- To explore potential early-life predictors for adult COPD.
Main Methods:
- A population-based mother-child cohort (3290 pairs) in Copenhagen was followed from pregnancy (1959-1961) through childhood (ages 1, 3, 6).
- COPD was ascertained via national registries for hospitalizations and medication since 1994.
- Spirometry was performed at age 50 in a subgroup (930 individuals).
Main Results:
- 1 in 4 children experienced asthma-like symptoms.
- Childhood asthma-like symptoms were associated with a 1.88-fold increased hazard ratio for COPD hospitalization and a 2.27-fold odds ratio for long-acting muscarinic antagonist prescriptions.
- These symptoms correlated with reduced FEV1 and FEV1/FVC ratio at age 50, and a nearly doubled odds of Global Initiative for Chronic Obstructive Lung Disease stage >1 COPD.
Conclusions:
- Early childhood asthma-like symptoms represent a significant risk factor for developing COPD.
- This 60-year prospective study demonstrates a doubled risk of COPD in individuals with a history of childhood respiratory symptoms.
- Findings highlight the importance of early life respiratory health in predicting adult lung disease.
Background:
Chronic obstructive pulmonary disease (COPD) may originate in early life and share disease mechanisms with asthma-like symptoms in early childhood. This possibility remains unexplored on account of the lack of long-term prospective studies from infancy to the onset of COPD.
Objective:
We aimed to investigate the relationship between asthma-like symptoms in young children and development of COPD.
Methods:
In a population-based cohort of women who gave birth at the central hospital in Copenhagen during period from 1959 to 1961, we investigated data from 3290 mother-child pairs who attended examinations during pregnancy and when the children were aged 1, 3, and 6 years. COPD was assessed from the Danish national registries on hospitalizations and prescription medication since 1994. A subgroup of 930 individuals underwent spirometry testing at age 50 years.
Results:
Of the 3290 children, 1 in 4 had a history of asthma-like symptoms in early childhood. The adjusted hazard ratio for hospitalization for COPD was 1.88 (95% CI = 1.32-2.68), and the odds ratio for prescription of long-acting muscarinic antagonists was 2.27 (95% CI = 1.38-3.70). Asthma-like symptoms in early childhood were also associated with a reduced FEV1 percent predicted and an FEV1-to-forced vital capacity ratio at age 50 years (-3.36% [95% CI = -5.47 to -1.24] and -1.28 [95% CI = -2.17 to -0.38], respectively) and with COPD defined according to Global Initiative for Chronic Obstructive Lung Disease stage higher than 1 (odds ratio = 1.96 [95% CI = 1.13-3.34]).
Conclusion:
This 60-year prospective follow-up of a mother-child cohort demonstrated a doubled risk for COPD from childhood asthma-like symptoms.
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