Abstract

There are several important antenatal factors including maternal stress, tobacco smoking, air pollution and nutrition that have been shown to influence lung development in utero and beyond. Exposure to these is associated with detrimental lung function and respiratory morbidity in childhood that can persist into adulthood. Environmental factors in utero may influence adult disease, referred to as fetal programming. This chapter reviews the proposed underlying mechanisms behind the effect on lung development including neurohormonal, immune, inflammatory and epigenetic pathways. There is a significant impact of sociodemographic inequalities on each of these antenatal determinants of child lung development, even in countries with a universally free healthcare system. As such, it is important that we do not refer to these simply as “lifestyle choices of expectant mothers”, but rather aim to tackle these inequalities and provide equitable antenatal care and education to women in pregnancy to improve lifelong respiratory health.

Cite as: Holden KA, Gibson M, Sinha IP, et al. Antenatal determinants of child lung development. In: Sinha IP, Lee A, Katikireddi SV, et al., eds. Inequalities in Respiratory Health (ERS Monograph). Sheffield, European Respiratory Society, 2023; pp. 99–115 [https://doi.org/10.1183/2312508X.10016222].