Association of maternal anemia with increased wheeze and asthma in children

Abstract

IntroductionAsthma and respiratory disease account for increasing childhood morbidity, placing a burden on the health care system and on affected individuals and families. In 2007, approximately 6.7 million children under the age of 18 had asthma [1], with rates increasing to nearly 7 million (9.4%) by 2008 [2]. As of 2008, more than 14% of children 0-17 had been diagnosed with asthma [2], with children 0-4 years demonstrating the greatest use of health care services for asthma related illness [1]. Increases in childhood respiratory disease over the past decades have highlighted the need to identify specific factors associated with © 2010 American College of Allergy, Asthma and Immunology. Published by Elsevier Inc. All rights reserved.Corresponding Author and Request for Reprints: Elizabeth W. Triche, Brown University, Department of Community Health/ Epidemiology, Box G-S121-2, 121 S. Main St., Providence, RI 02912, Tel: 401 863-1987, Fax: 401 863-3713, Elizabeth_triche@brown.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflict of Interest:Michael Bracken and Paige Wickner work as occasional contractors for Pfizer although the research in this paper is not related in any way to compensation received from this company. All other authors do not have any conflict of interest. early childhood wheezing and childhood asthma. The rise in prevalence of asthma is too rapid to be due to genetic mutations, and air pollution has actually declined in many areas where asthma rates have been increasing. NIH Public AccessRecent research has suggested that maternal dietary factors during pregnancy may influence the development of childhood asthma [3,4]. The intrauterine environment provides the substrate for many important processes including lung and early immune system development, and support of optimal fetal growth requires adequate maternal nutritional status. Lung development in-utero is apparent within 3-4 weeks after fertilization and continues throughout gestation and childhood [5]. [6] It is possible, then, that inadequate nutritional status during gestation may negatively impact childhood respiratory health [3,4], particularly during critical periods of embryonic and fetal growth.Maternal anemia, an indicator of overall nutritional status, has been linked to a number of adverse outcomes including infant mortality, preterm delivery, poor gestational weight gain, low birth weight, and poor infant neurocognitive performance [7][8][9]. Anemia is prevalent in the 4 pregnant population in the United States (9.3% in the general pregnant population and up to 27% in low incom...

Prenatal folic acid and risk of asthma in children: a systematic review and meta-analysis

“…Results from the other studies in our review did not confirm this finding (22, 24–26, 28, 29); however, none of these studies were of a size that would allow them to detect an estimate so modestly elevated.…”

“…Five studies (22, 24, 26, 28, 29) examined the association of folate (folic acid use not dichotomized as yes or no, dietary folate, or blood folate measurements) in the first trimester with childhood asthma or wheezing (12 comparisons); no significantly increased risks were reported.…”

“…Other studies also showed that maternal folic acid supplement use was associated with maternal self-report of asthma or allergy (22, 26, 35). Several studies reported that children with asthma, wheezing, or atopy were significantly more likely to have allergic mothers (29, 30, 32, 33), and 2 studies reported oversampling of allergic mothers by study design (26, 30). In addition, Kiefte-de Jong et al (22) reported that mothers who used supplements were significantly different from mothers who did not use supplements for 12 of 16 maternal and child characteristics including the following: birth weight, parental history of atopy, age, ethnicity, education, and smoking and alcohol use during pregnancy.…”

The origins of health and disease: the influence of maternal diseases and lifestyle during gestation

“…Iron deficiency can also increase the risk of maternal infections, which can stimulate the production of CRH and are a major risk factor for preterm delivery [55]. ” Moreover, offspring of mother with anemia had doubled risk of wheezing (OR = 2.42) and more than triple the risk of current asthma at the age of six years (RR = 3.46) [56]. On the basis of such evidences, the fact that low to moderate dose iron supplementation in early pregnancy benefits fetal growth in women with iron deficiency is not surprising.…”

Maternal Obesity Affects Inflammatory and Iron Indices in Umbilical Cord Blood

“…15,16 Maternal iron deficiency during pregnancy has also been linked to a higher likelihood of childhood wheezing. 17,18 An additional study found that lower umbilical tissue iron content was linked to childhood wheezing, 19 but did not measure immune indices at birth. We previously found poorer umbilical cord blood iron status in the presence of maternal obesity or with GWG exceeding 18 kg 13 and also demonstrated that either poor umbilical cord iron status or GWG exceeding 18 kg predicted the development of eosinophilia during the first year of life.…”