"What are my chances of developing COPD if one of my parents has the disease?" A systematic review and meta-analysis of prevalence of co-occurrence of COPD diagnosis in parents and offspring.
BACKGROUND
Intergenerational associations in chronic obstructive pulmonary disease (COPD) have been well recognized and may result from genetic, gene environment, or exposure to life course factors. Consequently, adult offspring of parents with COPD may be at a greater risk of developing COPD. The aim of this study was to review the prevalence of co-occurrence of COPD in adult offspring with one or both parents having COPD independent of specific genetic variations.


METHODS
In total, five databases were searched for original studies in which prevalence of COPD was reported in both offspring (children) and one or both parents. Studies were excluded if COPD was not clearly defined, COPD was linked to specific genetic variations, COPD was combined with other chronic respiratory conditions, or estimates included other first-degree relatives. Data extraction (ie, sample characteristics, prevalence of COPD, and odds ratio [OR] if reported) was completed by two independent reviewers. A meta-analysis of prevalence and OR was conducted, where possible.


RESULTS
Of the 3,382 citations, 129 full texts were reviewed to include eight studies (six case-control, one cross-sectional, and one cohort) reflecting either prevalence of COPD in offspring of parents with COPD (descendent approach, n=3), which ranged from 0% to 17.3%, or prevalence of people with COPD reporting positive parental history of COPD (antecedent approach, n=5), for which the pooled prevalence was 28.6%. Offspring of people with COPD had 1.57 times greater odds (95% confidence interval =1.29-1.93;P<0.001) of having COPD compared with people not having a parental history of COPD.


CONCLUSIONS
The prevalence of COPD in adult offspring of people with COPD is greater than population-based estimates, and the ORs indicate a higher risk in this group. This offers clinicians a potential strategy for opportunistic screening, early identification, and intervention in this at-risk group.
School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia.
Lok Sze Katrina
LS
Li
Center for Population Health Research, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia.
Catherine
C
Paquet
School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia.
Kylie
K
Johnston
Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
Marie T
MT
Williams
D016241:Child of Impaired Parents; D020022:Genetic Predisposition to Disease; D040941:Heredity; D006801:Humans; D008019:Life Style; D008168:Lung / Q000503:physiopathology; D016017:Odds Ratio; D010375:Pedigree; D010641:Phenotype; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors
COPD; intergenerational; prevalence; systematic review