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Review
. 2025 Jun;155(6):1703-1719.
doi: 10.1016/j.jaci.2025.04.012. Epub 2025 Apr 17.

Understanding the childhood origins of asthma and chronic obstructive pulmonary disease: Insights from birth cohorts and studies across the life-span

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Review

Understanding the childhood origins of asthma and chronic obstructive pulmonary disease: Insights from birth cohorts and studies across the life-span

Tina Hartert et al. J Allergy Clin Immunol. 2025 Jun.
Free article

Abstract

Birth cohorts have identified modifiable risk factors for asthma and respiratory health in children and adults, demonstrating the important role and pathways through which early-life events influence not only child outcomes but also adult health, disease, and mortality. This focused literature update from 2021 to 2024 summarizes birth cohort studies across the life-span that contribute to our understanding of risk factors for and the childhood origins of asthma and chronic obstructive pulmonary disease that may inform prevention efforts. We conclude that there are critical periods of developmental plasticity and susceptibility during which early-life events and exposures likely have the greatest impact on the development of asthma and chronic obstructive lung disease phenotypes, and that there are important prenatal and early childhood exposures, which, if modified, might be candidates for improving respiratory health across the life-span. Birth cohorts have been and will continue to be critical to advancing our understanding of lung health and disease across the life-span, including asthma and chronic obstructive pulmonary disease. As child mortality declines and the human population ages, data from birth cohort studies are needed to inform strategies for optimizing healthy longevity, including the investment in understanding the lifelong consequences of adverse prenatal and early childhood exposures.

Keywords: Asthma; COPD; birth cohort; developmental origins of health and disease; lung function; risk factors; studies across the life-span; wheeze.

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Conflict of interest statement

Disclosure statement Disclosure of potential conflict of interest: T. Hartert reports grants from the NIH; fees from the American Thoracic Society, the Parker B Francis Council of Scientific Advisors, the NIH National Health Lung and Blood Institute for serving on council; from Pfizer for serving on vaccine data safety monitoring boards; speaker fees for invited talks from the American Academy of Allergy, Asthma & Immunology and for serving as an expert content writer for UpToDate. J. P. Allinson has received lecture fees from AstraZeneca. H. J. Zar is supported by the South African Medical Research Council; reports grants from AstraZeneca, Merck, and Pfizer for trials of respiratory syncytial virus (RSV) prevention and from the Gates Foundation for studies in childhood pneumonia (including RSV); has served on advisory boards of Merck and Pfizer on RSV prevention; has received speaker fees from Pfizer; serves on a data safety monitoring board for Moderna outside of the submitted work; and has served on the World Health Organization Technical Advisory Group on new RSV preventive interventions. The rest of the authors declare that they have no relevant conflicts of interest.

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