Very-to-moderate preterm birth almost trebles the risk of COPD at age 53 years, according to the latest data from the Tasmanian Longitudinal Health Study (TAHS).
The study, published in the Lancet Respiratory Medicine, confirms the multifactorial determinants of COPD – including early life exposures – beyond a history of smoking.
An analysis of 1,445 participants in the TAHS cohort identified that <4% were born very to moderate preterm (28-34 weeks gestational age), 12% late preterm (34-37 weeks), and 85% full term (at least 37 weeks).
Almost half (46%) were never smokers, 39% were past smokers and 15% were current smokers at the 53 year follow-up.
“After adjusting for sex, age, adult height, maternal age at birth, number of older siblings, maternal and paternal smoking, and family socioeconomic status in early life, very-to-moderate preterm birth was significantly associated with increased risk of COPD at age 53 years compared with term birth (odds ratio [OR] 2·9 [95% CI 1·1–7·7]).”
Very-to-moderate preterm birth was also significantly associated with poorer lung function – lower post-bronchodilator FEV1/FVC ratio, FEV1 , DLCO, and FEF 25–75%.
“FEV1 and FEV1/FVC ratio declined more rapidly between ages 45 years and 53 years in the very-to-moderate preterm group than in the term,” the study said.
It also found a significant interaction between very-to-moderate prematurity and current smoking status with the OR for COPD rising to 4.3.