European Journal of Epidemiology

, Volume 29, Issue 12, pp 871–885 | Cite as

Early origins of chronic obstructive lung diseases across the life course

  • Liesbeth Duijts
  • Irwin K. Reiss
  • Guy Brusselle
  • Johan C. de Jongste


Chronic obstructive lung diseases, like asthma and chronic obstructive pulmonary disease, have high prevalences and are a major public health concern. Chronic obstructive lung diseases have at least part of their origins in early life. Exposure to an adverse environment during critical periods in early life might lead to permanent developmental adaptations which results in impaired lung growth with smaller airways and lower lung volume, altered immunological responses and related inflammation, and subsequently to increased risks of chronic obstructive lung diseases throughout the life course. Various pathways leading from early life factors to respiratory health outcomes in later life have been studied, including fetal and early infant growth patterns, preterm birth, maternal obesity, diet and smoking, children’s diet, allergen exposure and respiratory tract infections, and genetic susceptibility. Data on potential adverse factors in the embryonic and preconception period and respiratory health outcomes are scarce. Also, the underlying mechanisms how specific adverse exposures in the fetal and early postnatal period lead to chronic obstructive lung diseases in later life are not yet fully understood. Current studies suggest that interactions between early environmental exposures and genetic factors such as changes in DNA-methylation and RNA expression patterns may explain the early development of chronic obstructive lung diseases. New well-designed epidemiological studies are needed to identify specific critical periods and to elucidate the mechanisms underlying the development of chronic obstructive lung disease throughout the life course.


Cohort study Child Asthma Chronic Obstructive Pulmonary Disease (COPD) Early origins 



Liesbeth Duijts received funding from the Lung Foundation Netherlands (no; 2012).

Conflict of interest

The authors have no conflict of interest.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Liesbeth Duijts
    • 1
    • 2
    • 3
  • Irwin K. Reiss
    • 2
  • Guy Brusselle
    • 3
    • 4
    • 5
  • Johan C. de Jongste
    • 1
  1. 1.Division of Respiratory Medicine (Sp-3435), Department of PediatricsErasmus Medical CenterRotterdamThe Netherlands
  2. 2.Division of Neonatology, Department of PediatricsErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Department of EpidemiologyErasmus Medical CenterRotterdamThe Netherlands
  4. 4.Department of Respiratory MedicineErasmus Medical CenterRotterdamThe Netherlands
  5. 5.Department of Respiratory MedicineGhent University HospitalGhentBelgium

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