Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish National Birth Cohort

Harpsøe, Maria C.; Basit, Saima; Bager, Peter; Wohlfahrt, Jan; Benn, Christine Stabell; Nøhr, Ellen Aagaard; Linneberg, Allan; Jess, Tine

doi:10.1016/j.jaci.2012.09.008

Cited by 130 publications

(187 citation statements)

References 52 publications

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“…Of these, 14 studies with a total of 108 321 mother-child pairs were included in the meta-analysis [16][17][18][20][21][22][23][24][25][26][27][28][29][30] (Table 1). There was complete agreement on 469 of 474 articles after title and abstract screening (interreader agreement k = .90) and on 40 of 42 articles after full-text screening (k = .89).…”

Section: Resultsmentioning

confidence: 99%

Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma

et al. 2014

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BACKGROUND AND OBJECTIVE: Environmental or lifestyle exposures in utero may influence the development of childhood asthma. In this meta-analysis, we aimed to assess whether maternal obesity in pregnancy (MOP) or increased maternal gestational weight gain (GWG) increased the risk of asthma in offspring. METHODS: We included all observational studies published until October 2013 in PubMed, Embase, CINAHL, Scopus, The Cochrane Database, and Ovid. Random effects models with inverse variance weights were used to calculate pooled risk estimates. RESULTS: Fourteen studies were included (N = 108 321 mother–child pairs). Twelve studies reported maternal obesity, and 5 reported GWG. Age of children was 14 months to 16 years. MOP was associated with higher odds of asthma or wheeze ever (OR = 1.31; 95% confidence interval [CI], 1.16–1.49) or current (OR = 1.21; 95% CI, 1.07–1.37); each 1-kg/m2 increase in maternal BMI was associated with a 2% to 3% increase in the odds of childhood asthma. High GWG was associated with higher odds of asthma or wheeze ever (OR = 1.16; 95% CI, 1.001–1.34). Maternal underweight and low GWG were not associated with childhood asthma or wheeze. Meta-regression showed a negative association of borderline significance for maternal asthma history (P = .07). The significant heterogeneity among existing studies indicates a need for standardized approaches to future studies on the topic. CONCLUSIONS: MOP and high GWG are associated with an elevated risk of childhood asthma; this finding may be particularly significant for mothers without asthma history. Prospective randomized trials of maternal weight management are needed.

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Section: Resultsmentioning

confidence: 99%

Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma

et al. 2014

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“…Some of the most important factors linking asthma with obesity are birth weight, both low and high (49) , and breast-feeding (62) . In addition, poor maternal diet, low in micronutrients such as vitamins D, E and C, and maternal weight gain during pregnancy were shown to increase the chances of the offspring having asthma and/or obesity later in life (91)(92)(93)(94)(95) . These factors could contribute to the coexistence of these two conditions (86) ; however, the evidence is rather ambiguous.…”

Section: Possible Linksmentioning

confidence: 99%

Association between obesity and asthma – epidemiology, pathophysiology and clinical profile

2016

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Obesity is a risk factor for asthma, and obese asthmatics have lower disease control and increased symptom severity. Several putative links have been proposed, including genetics, mechanical restriction of the chest and the intake of corticosteroids. The most consistent evidence, however, comes from studies of cytokines produced by the adipose tissue called adipokines. Adipokine imbalance is associated with both proinflammatory status and asthma. Although reverse causation has been proposed, it is now acknowledged that obesity precedes asthma symptoms. Nevertheless, prenatal origins of both conditions complicate the search for causality. There is a confirmed role of neuro-immune cross-talk mediating obesityinduced asthma, with leptin playing a key role in these processes. Obesity-induced asthma is now considered a distinct asthma phenotype. In fact, it is one of the most important determinants of asthma phenotypes. Two main subphenotypes have been distinguished. The first phenotype, which affects adult women, is characterised by later onset and is more likely to be non-atopic. The childhood obesity-induced asthma phenotype is characterised by primary and predominantly atopic asthma. In obesity-induced asthma, the immune responses are shifted towards T helper (Th) 1 polarisation rather than the typical atopic Th2 immunological profile. Moreover, obese asthmatics might respond differently to environmental triggers. The high cost of treatment of obesity-related asthma, and the burden it causes for the patients and their families call for urgent intervention. Phenotype-specific approaches seem to be crucial for the success of prevention and treatment.

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“…We measured the main respiratory symptom outcome in our study using International Study on Asthma and Allergy in Childhood questionnaires. Although this method is validated from the age of 7 years, it is widely accepted in epidemiological studies among younger children [32][33][34] , and reliably reflects the incidence of asthma symptoms in young children. 35 An earlier Dutch birth cohort study used identical International Study on Asthma and Allergy in Childhood questions, and observed similar prevalences of wheezing based on the International Study on Asthma and Allergy in Childhood questionnaires as in our study.…”

Section: Maternal Fish Consumption and Atopic Symptoms Etm Leermakersmentioning

confidence: 99%

Maternal fish consumption during pregnancy and risks of wheezing and eczema in childhood: The Generation R Study

et al. 2013

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BACKGROUND/OBJECTIVES: Maternal fish consumption during pregnancy might influence the fetal immune system through anti-inflammatory effects of omega-3 fatty acids, and might affect the risks of childhood asthma and atopy. In Generation R, a prospective cohort study in the Netherlands, we examined the associations of first trimester fish consumption with childhood wheezing and eczema in the first 4 years of life. METHODS: In total, 2976 mothers completed a 293-item semiquantitative food frequency questionnaire covering dietary intake in the first trimester. The occurrence of wheezing and eczema was yearly assessed by questionnaires. RESULTS: Median weekly fish consumption was 83 (95% range 0-316) grams per week. We observed no consistent associations of maternal total-, lean-or fatty-fish consumption during pregnancy with the risks of childhood wheezing. Maternal shellfish consumption of 1-13 g per week was associated with overall increased risks of childhood wheezing and eczema (OR 1.20 (1.04, 1.40) and OR 1.18 (1.01, 1.37), respectively). Maternal fatty fish consumption of 35-69 g per week was associated with increased overall risks of childhood eczema (OR 1.17 (1.00, 1.38)), but maternal total-or lean-fish consumption was not. CONCLUSIONS: During pregnancy, shellfish consumption was associated with increased risks of wheezing and eczema, while fatty fish consumption was associated with a higher risk of eczema only. Maternal total fish or lean fish consumption were not associated with wheezing or eczema. Further studies are needed to replicate these findings and to explore underlying mechanisms.

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Maternal obesity, gestational weight gain, and risk of asthma and atopic disease in offspring: A study within the Danish National Birth Cohort

Cited by 130 publications

References 52 publications

Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma

Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma

Association between obesity and asthma – epidemiology, pathophysiology and clinical profile

Maternal fish consumption during pregnancy and risks of wheezing and eczema in childhood: The Generation R Study

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