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Copyright ©ERS Journals Ltd 2002
Perinatal predictors of respiratory symptoms and lung function at a young adult age
Depts of 1 Epidemiology, University of Groningen, Groningen, 2 Paediatric Pulmonology, Academic Medical Centre, University of Amsterdam, Amsterdam, 3 Paediatrics, Isala Klinieken, Zwolle, 4 Paediatric Pulmonology, University Hospital Groningen, Groningen and 5 Obstetrics & Gynecology, University Hospital Groningen, Groningen, the Netherlands
CORRESPONDENCE: H.M. Boezen, Dept of Epidemiology, University of Groningen, Ant. Deusinglaan 1, PO Box 196, 9700 AD, Groningen, The Netherlands. Fax: 31 503633082. E-mail: h.m.boezen@med.rug.nl
Keywords: cohort study, lung function, perinatal predictors, respiratory symptoms, young adults
Received: April 5, 2001
Accepted November 14, 2001
This study was supported by the Netherlands Asthma Fund, the Netherlands (grant 96.28) Stichting Astma Bestijding, the Netherlands.
A longitudinal cohort of 2,957 babies, born in 1975–1978, was used to investigate whether perinatal factors predict respiratory morbidity at a young adult age.
In 1997, the presence of asthmatic (wheeze, nocturnal dyspnoea) and bronchitic (cough, phlegm, dyspnoea grade 3) symptoms and the level of lung function was determined in this cohort. The independent association between smoking during pregnancy, being first-born, birth weight and respiratory symptoms and lung function at young adult age was investigated using multiple regression models, taking other potential risk factors into account.
Of 1,568 responders, 608 (39%, aged 18–22 yrs) had at least one respiratory symptom. The young adults who had a mother that smoked during pregnancy had a significantly lower level of lung function than their nonintra-uterine exposed peers (regression coefficient (B) (standard error): peak expiratory flow (PEF) –0.257 (0.131) L·s–1; forced expiratory flow when 25% of the forced vital capacity has been exhaled (FEF25) –0.290 (0.129) L·s–1), although they were not at increased risk of having respiratory symptoms. Young adults who were first-born had better levels of lung function (B (se): forced expiratory volume in one second (FEV1) 0.090 (0.042) L) and were less likely to have asthmatic symptoms (odds ratio (95% confidence interval): 0.58 (0.35–0.95)) than those not first-born. Low birth weight (FEV1 –0.013 (0.004) L for a reduction of 100 g) was also predictive of reduced achieved levels of lung function at young adult age, independent of other potential risk factors, e.g. current smoking habits or familial predisposition.
This study adds to the knowledge of the role of perinatal factors, such as smoking during pregnancy, as important predictors of respiratory morbidity.
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