Pulmonary function and asthma risk may depend on fetal and infant growth patterns
IUGR babies with catch-up growth and the "fat happy wheezers" are most likely at risk for lower lung function.
The Dutch study by Liesbeth Duijts adds important information to the well known concept that intrauterine period and early life have an key role in the development of the lung and in the onset of respiratory diseases. The authors followed-up 5635 children looking for specific growth patterns during fetal and early life that could affect pulmonary function. The results indicate that intrauterine or infant growth alone are not responsible for pulmonary function but that it is the combination of the two that affects the development of a normal respiratory function. A reduced growth since birth to the third month of life could predispose to asthma at the age of 10 years, while an intrauterine growth restriction followed by accelerated growth (the catch-up growth) would not affect the development of asthma but could cause a reduction in the pulmonary function. An accelerated growth during the first 3 months of life could also be associated with increased values of FVC but with a reduced FEV1/FVC ratio. This latter scenario, explained by the dysanapsis phenomenon, indicate a disproportion between lung volume and the caliber of the airways resulting in reduced lung function.
den Dekker HT, Jaddoe VWV, Reiss IK, de Jongste JC, Duijts L. Fetal and Infant Growth Patterns and Risk of Lower Lung Function and Asthma. The Generation R Study. Am J Respir Crit Care Med. 2017 Sep 20.