Barker D J, Godfrey K M, Fall C, Osmond C, Winter P D, Shaheen S O
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital.
BMJ. 1991 Sep 21;303(6804):671-5. doi: 10.1136/bmj.303.6804.671.
To examine whether birth weight, infant weight, and childhood respiratory infection are associated with adult lung function and death from chronic obstructive airways disease.
Follow up study of men born during 1911-30 whose birth weights, weights at 1 year, and childhood illnesses were recorded at the time by health visitors.
Hertfordshire, England.
5718 men born in the county during 1911-30 and a subgroup of 825 men born in the county during 1920-30 and still living there.
Death from chronic obstructive airways disease, mean forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), and respiratory symptoms.
55 men died of chronic obstructive airways disease. Death rates fell with increasing birth weight and weight at 1 year. Mean FEV1 at age 59 to 70 years, adjusted for height and age, rose by 0.06 litre (95% confidence interval 0.02 to 0.09) with each pound (450 g) increase in birth weight, independently of smoking habit and social class. Bronchitis or pneumonia in infancy was associated with a 0.17 litre (0.02 to 0.32) reduction in adult FEV1 and with an increased odds ratio of wheezing and persistent sputum production in adult life independently of birth weight, smoking habit, and social class. Whooping cough in infancy was associated with a 0.22 litre (0.02 to 0.42) reduction in adult FEV1.
Lower birth weight was associated with worse adult lung function. Intrauterine influences which retard fetal weight gain may irrecoverably constrain the growth of the airways. Bronchitis, pneumonia, or whooping cough in infancy further reduced adult lung function. They also retarded infant weight gain. Consistent with this, death from chronic obstructive airways disease in adult life was associated with lower birth weight and weight at 1 year. Promoting lung growth in fetuses and infants and reducing the incidence of lower respiratory tract infection in infancy may reduce the incidence of chronic obstructive airways disease in the next generation.
研究出生体重、婴儿期体重及儿童期呼吸道感染是否与成人肺功能及慢性阻塞性气道疾病死亡相关。
对1911年至1930年间出生的男性进行随访研究，当时健康访视员记录了他们的出生体重、1岁时体重及儿童期疾病情况。
英国赫特福德郡。
1911年至1930年间在该郡出生的5718名男性，以及1920年至1930年间在该郡出生且仍居住在当地的825名男性组成的亚组。
慢性阻塞性气道疾病死亡、一秒用力呼气容积（FEV1）均值和用力肺活量（FVC）均值以及呼吸道症状。
55名男性死于慢性阻塞性气道疾病。死亡率随出生体重和1岁时体重增加而降低。在59至70岁时，校正身高和年龄后，出生体重每增加一磅（450克），FEV1均值增加0.06升（95%置信区间为0.02至0.09），与吸烟习惯和社会阶层无关。婴儿期患支气管炎或肺炎与成人FEV1降低0.17升（0.02至0.32）相关，且与成年后喘息和持续咳痰的比值比增加相关，与出生体重、吸烟习惯和社会阶层无关。婴儿期患百日咳与成人FEV1降低0.22升（0.02至0.42）相关。
出生体重较低与成人肺功能较差相关。阻碍胎儿体重增加的宫内因素可能会不可逆转地限制气道生长。婴儿期患支气管炎、肺炎或百日咳会进一步降低成人肺功能。它们还会阻碍婴儿体重增加。与此一致的是，成年期慢性阻塞性气道疾病死亡与较低的出生体重和1岁时体重相关。促进胎儿和婴儿期肺生长并降低婴儿期下呼吸道感染发生率可能会降低下一代慢性阻塞性气道疾病的发生率。
