The womb and lung function later in life

Abstract

The information about the in utero influences on the development of the lungs and lung function is limited. No measurements are available at present to objectify this, and all studies in humans describing early determinants of airway function mention placental function, birth weight in relation to gestational age, sex and ethnicity, environmental factors, such as smoking, nutrition of the mother, and respiratory infections of the neonate. In fact, the womb is a black box where many factors influence the development of the foetus and, in particular, the lungs. Another complicating factor is that before birth the lungs are not involved in gas exchange and are not fully expanded. Negative effects on lung development can result from either: mother-related factors, including hypoxia, intoxications and other causes of intra-uterine stress, like pre-eclampsia, which leads to growth retardation and often to premature birth; or child-related factors, such as foetal diseases like congenital renal abnormalities and diaphragmatic hernias. In this issue, Greenough et al. 1 present interesting data on the effects of intra-uterine growth retardation (IUGR), in children born prematurely, on the severity of lung function impairment. The most important findings of their study include a significant relationship between airway resistance, on the one hand, and IUGR, maternal smoking and bronchopulmonary dysplasia, on the other hand. Almost no data on the impact of IUGR on lung function during infancy are available, until now, despite the known association between IUGR, subsequent …