Early Life Risk Factors

Early Life Risk Factors That Affect Lung Health

Lung health can be significantly influenced by conditions and exposures during pregnancy and early childhood. From nutritional deficiencies to environmental pollutants, a wide range of factors may contribute to respiratory problems later in life. Our team at Dr. Mutha Hospital, known for comprehensive lung care and paediatric pulmonology, explains these early risk factors and their impact.

Pre-Birth Problems with Lung Development

Lungs may not always develop properly while a baby is in the womb. When lung growth is restricted, a baby’s chance of survival after birth is significantly reduced. In fact, abnormal lung development accounts for 15–20% of deaths in new-borns.

Common causes include:

• Reduced space in the womb

• Genetic conditions

• Nutritional deficiencies, especially Vitamin A, which is vital for fetal lung growth

Medical Interventions to Improve Fetal Lung Growth

While fetal lung issues are difficult to treat, certain procedures may be considered:

• Amnio-infusion: Injecting fluid into the womb to compensate for low amniotic fluid. This improves ultrasound clarity but does not directly enhance lung growth.

• Thoraco-amniotic shunting: A device is inserted into the baby’s chest to drain excess fluid that could affect lung development. However, it’s typically done too late for major benefits.

• Balloon tracheal occlusion: A promising technique where a small balloon is placed in the baby’s trachea to retain lung fluid and encourage lung expansion, especially in cases of congenital diaphragmatic hernia.

Low Birth Weight and Preterm Birth

Babies born with low birth weight are more vulnerable to:

• Lung infections

• Wheezing

• Reduced lung function

Preterm birth (before 36 weeks) further increases these risks. The younger the baby at birth, the more underdeveloped the lungs are.

Bronchopulmonary Dysplasia (BPD)

A common condition in premature babies, BPD occurs in infants needing oxygen therapy for over 28 days. It results in:

• Enlarged, fewer alveoli

• Fewer blood vessels

• Difficulty breathing

Symptoms may include rapid breathing, wheezing, and gasping. While some children recover, others may experience chronic lung conditions like COPD later in life. At Dr. Mutha Hospital, our chest specialists monitor such high-risk infants closely to reduce long-term damage.

The Impact of Passive Smoking

Babies exposed to passive smoke face increased risks before and after birth. Maternal smoking is linked to:

• Premature delivery

• Low birth weight

• Higher rates of asthma and bronchitis

• A 72% increased risk of lung disease in children under 2

Passive smoke exposure can lead to wheezing, chronic cough, pneumonia, and increased hospital visits. Parental smoking is responsible for around 20% of childhood asthma cases.

Lung Infections in Infancy

Respiratory infections in infancy can leave lasting damage:

• Respiratory Syncytial Virus (RSV) is the most common. While it resembles a cold in mild cases, severe RSV can cause persistent wheezing and may require hospitalization.

  • 30–50% of children who wheeze due to RSV go on to develop asthma.

Other concerning viruses include:

• Adenovirus

• Human metapneumovirus

• Rhinovirus

These infections can lead to long-term lung sensitivity and increased chances of developing asthma or chronic bronchitis later in life.

Wheezy Bronchitis and Long-Term Effects

Infants diagnosed with wheezy bronchitis are at higher risk of:

• Lung function decline after age 50

• Developing chronic obstructive pulmonary disease (COPD)

These early respiratory issues often stem from both environmental triggers and genetic predisposition, underlining the importance of early diagnosis and intervention.

Understanding the Lifelong Burden

• Abnormal lung development contributes to 15–20% of new-born deaths

• Parental smoking may cause 20% of all childhood asthma cases

• 20% of babies whose mothers smoked during pregnancy are hospitalized for bronchitis by age 5

• Children with severe RSV are significantly more likely to wheeze for years afterward

• A grandparent’s history of lung disease – especially smoking – can influence a grandchild’s lung health