Review Finds Parental COPD Associated With COPD in Offspring

A review published in the International Journal of Chronic Obstructive Pulmonary Disease found that there was an association between parental and offspring chronic obstructive pulmonary disease (COPD), with offspring of parents with COPD having an increased risk of developing COPD themselves.

The researchers used the Embase and Ovid MEDLINE databases to search for studies to include in the review and also used the help of a research librarian. Criteria for parental and offspring COPD were broad so that the researchers could capture studies that used definitions other than COPD. The researchers defined COPD as COPD, emphysema, chronic bronchitis, chronic respiratory symptoms, or chronic respiratory diseases. Diagnosis could be based on spirometry, self-reported information, or medical records.

Studies that were written in languages other than English or Nordic languages were excluded. Original reports were the only studies included.

There were 13 studies included in this review. The studies included were conducted in the United States, Europe, and Asia, and 1 was a multicenter study; 6 studies were published prior to 2010. All studies included were observational studies, with most of the studies using a case-control study design. The studies also included 1 cohort study and 2 cross-sectional studies.

Patients were 45 years or older, on average, in all studies that used an antecedent approach (ie, offspring with COPD reporting parental COPD) and aged 27 to 41 years in studies that used a descendant approach (ie, the index person was the parent with COPD and cases were defined as the offspring of the index person).

All studies but 1 found an increased risk of COPD in participants with parental COPD. Prevalence in studies that used an antecedent approach ranged from 19% to 58%; prevalence in studies using the descendant approach ranged from 0% to 17%.

A study found that there was a higher prevalence of parental COPD in non-Hispanic White patients (37.1%) compared with African American patients (19.3%), but the adjusted odds ratio (OR) did not differ substantially (1.77 [95% CI, 1.55-2.03] vs 1.71 [95% CI, 1.35-2.17], respectively).

There were 2 studies that reported on early-onset COPD prevalence, in which 1 found almost the same prevalence associated with maternal (23%) vs paternal (21%) exposure. One study that found that the standard incidence ratio (SIR) of COPD for offspring was higher when biological parents had COPD (SIR, 1.98; 95% CI, 1.69-2.31) compared with adopted parents (SIR, 1.12; 95% CI, 0.92-1.35).

Parents with COPD who smoked had a significant association with offspring with COPD (OR, 1.73; 95% CI, 1.36-2.20) when adjusting for demographics, parental COPD, parental smoking, and childhood tobacco smoke.

Patients with parental COPD had lower forced expiratory volume, more dyspnea, lower quality of life, and higher number of severe exacerbations compared with those who had COPD but no parental COPD.

There were some limitations to this study. The language restriction may have led to studies being missed. No quality test was performed for the included studies. Studies that combined sibling and parental COPD or only evaluated sibling COPD were excluded from this review, which means that the share of sibling COPD was not taken into account when evaluating parental COPD.

The researchers concluded that the studies in the review demonstrated an association between parental COPD and the development of COPD in their offspring. The authors noted that this information can help in early COPD detection when evaluating family history.

Reference

Sikjær MG, Klitgaard A, Hilberg O, Løkke A. Parental COPD as a risk factor for the development of COPD and disease severity in offspring: a systematic scoping review. Int J Chron Obstruc Pulmon Dis. 2022;17:1323-1338. doi:10.2147/COPD.S364899