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Thus, we quantitatively evaluated the impact of different early life exposures on COPD in adulthood. The PubMed, Embase and Cochrane Library electronic databases were searched for articles published from January 2001 to October 2020. A total of 30 studies (795,935 participants) met the criteria and were included in the review. We found a significant association of COPD with childhood serious respiratory infections, pneumonia or bronchitis (pooled adjusted OR [aOR], 2.23 [95% CI, 1.63\u20133.07]). The probability of COPD was increased 3.45\u2010fold for children with than without asthma (pooled aOR, 3.45 [95% CI, 2.37\u20135.02]). In addition, the probability of COPD was associated with maternal smoking (pooled aOR, 1.42 [95% CI, 1.17\u20131.72]), any child maltreatment (pooled aOR, 1.30 [95% CI, 1.18\u20131.42]) and low birth weight (pooled aOR, 1.58 [95% CI, 1.08\u20132.32]) but not childhood environmental tobacco smoke exposure (pooled aOR, 1.15 [0.83\u20131.61]) or premature birth (pooled aOR, 1.17 [95% CI, 0.87\u20131.58]). Furthermore, subgroup analyses revealed that probability was increased for only women with childhood physical abuse, sexual abuse and exposure to intimate partner violence. Factors resulting in COPD in adults could trace back to early life. Childhood respiratory disease, maltreatment, maternal smoking and low birth weight increase the risk of COPD. Promising advances in prevention strategies for early life exposures could markedly decrease the risk of COPD.<\/jats:p>","DOI":"10.1111\/resp.14144","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T01:26:16Z","timestamp":1632101176000},"page":"1131-1151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Impact of early life exposures on\n                    <scp>COPD<\/scp>\n                    in adulthood: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"26","author":[{"given":"Pengfei","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine Shantou University Medical College  Shantou China"},{"name":"Department of Infectious Disease Prevention and Control The Zhongshan Second People's Hospital  Zhongshan 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