Prepregnancy body mass index and risk of childhood asthma

Rosenquist, Natalie A; Richards, Megan; Ferber, Jeannette; Li, De–Kun; Ryu, Seok Chang; Burkin, Heather R.; Strickland, Matthew; Darrow, Lyndsey A.

doi:10.1111/all.15598

Cited by 8 publications

(10 citation statements)

References 36 publications

(148 reference statements)

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“…We selected these three factors to evaluate because they impacted our previously reported associations between prepregnancy BMI and childhood asthma and could plausibly be on the causal pathway. 24 Previous studies have presented inconsistent results regarding the potential mediating effect of childhood BMI. Among studies that compared models with and without childhood BMI, they observed no or only small changes in their estimates.…”

Section: Discussionmentioning

confidence: 99%

“…study ended before child reached follow‐up age; Figure 1). Other details pertaining to the study population have been reported elsewhere 24 …”

Section: Methodsmentioning

confidence: 99%

“…The reporting guidelines checklist for observational research using routinely collected data (RECORD) 36 was complete for this study. 24 Analyses were completed in SAS 9.4 (SAS Institute, Cary, NC).…”

Section: Ethics Approvalmentioning

confidence: 99%

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Maternal obesity and childhood asthma risk: Exploring mediating pathways

Rosenquist,

Richards,

Ferber

et al. 2023

Paediatric Perinatal Epid

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BackgroundGrowing evidence for the effect of maternal obesity on childhood asthma motivates investigation of mediating pathways.ObjectiveTo investigate if childhood body mass index (BMI), gestational weight gain (GWG) and preterm birth mediate the association of maternal obesity on childhood asthma risk.MethodsWe used electronic medical records from mother–child pairs enrolled in Kaiser Permanente Northern California integrated healthcare system. Children were followed from their birth (2005–2014) until at least age 4 (n = 95,723), age 6 (n = 59,230) or age 8 (n = 25,261). Childhood asthma diagnosis at each age was determined using ICD‐9/10 codes and medication dispensings. Prepregnancy BMI (underweight [<18.5], normal [18.5–24.9], overweight [25–29.9], obese [≥30] kg/m2) were defined using height and weight measurements close to the last menstrual period date. Child's BMI (Centers for Disease Control and Prevention BMI‐for‐age percentiles: underweight [<5th], normal [5th–85th], overweight [85th–95th], obese [>95th]) were obtained using anthropometric measurements taken the year preceding each follow‐up age. GWG (delivery weight‐prepregnancy weight) was categorised based on Institutes of Medicine recommendations (inadequate, adequate, excessive). Implementing first causal inference test (CIT) then causal mediator models (to decompose the natural direct and indirect effects), we examined the potential mediating effect of childhood BMI, GWG, and preterm birth on the association between prepregnancy BMI (continuous and categorical) and childhood asthma.ResultsOverall, risk of childhood asthma increased as prepregnancy BMI increased (age 4 risk ratio: 1.07, 95% confidence interval: 1.04, 1.09, per 5 kg/m2 increase in BMI; similar for age 6 and 8). CIT identified childhood BMI and preterm birth, but not GWG as potential mediators. Causal mediation models confirmed childhood BMI, but not preterm birth, as having a partial mediating effect. Results were similar for age 6 and 8, and when continuous mediators (instead of binary) were assessed.ConclusionsChildhood overweight/obesity has a modest mediating effect on the association between prepregnancy BMI and childhood asthma.

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Section: Discussionmentioning

confidence: 99%

“…study ended before child reached follow‐up age; Figure 1). Other details pertaining to the study population have been reported elsewhere 24 …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Maternal obesity and childhood asthma risk: Exploring mediating pathways

Rosenquist,

Richards,

Ferber

et al. 2023

Paediatric Perinatal Epid

Self Cite

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“…We conducted several secondary analyses. We additionally adjusted for prenatal characteristics that may also confound the association between neighborhoods and childhood asthma: prenatal cigarette smoking, 26 prenatal secondhand smoke exposure, 27 prepregnancy BMI, 28 mode of delivery, 29 and gestational age. 30 We also adjusted for BMI in early childhood to explore the extent to which the associations may be explained by childhood adiposity.…”

Section: Discussionmentioning

confidence: 99%

Neighborhood Opportunity and Vulnerability and Incident Asthma Among Children

Aris,

Perng,

Dabelea

et al. 2023

JAMA Pediatr

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BackgroundThe extent to which physical and social attributes of neighborhoods play a role in childhood asthma remains understudied.ObjectiveTo examine associations of neighborhood-level opportunity and social vulnerability measures with childhood asthma incidence.Design, Setting, and ParticipantsThis cohort study used data from children in 46 cohorts participating in the Environmental Influences on Child Health Outcomes (ECHO) Program between January 1, 1995, and August 31, 2022. Participant inclusion required at least 1 geocoded residential address from birth and parent or caregiver report of a physician’s diagnosis of asthma. Participants were followed up to the date of asthma diagnosis, date of last visit or loss to follow-up, or age 20 years.ExposuresCensus tract–level Child Opportunity Index (COI) and Social Vulnerability Index (SVI) at birth, infancy, or early childhood, grouped into very low (&lt;20th percentile), low (20th to &lt;40th percentile), moderate (40th to &lt;60th percentile), high (60th to &lt;80th percentile), or very high (≥80th percentile) COI or SVI.Main Outcomes and MeasuresThe main outcome was parent or caregiver report of a physician’s diagnosis of childhood asthma (yes or no). Poisson regression models estimated asthma incidence rate ratios (IRRs) associated with COI and SVI scores at each life stage.ResultsThe study included 10 516 children (median age at follow-up, 9.1 years [IQR, 7.0-11.6 years]; 52.2% male), of whom 20.6% lived in neighborhoods with very high COI and very low SVI. The overall asthma incidence rate was 23.3 cases per 1000 child-years (median age at asthma diagnosis, 6.6 years [IQR, 4.1-9.9 years]). High and very high (vs very low) COI at birth, infancy, or early childhood were associated with lower subsequent asthma incidence independent of sociodemographic characteristics, parental asthma history, and parity. For example, compared with very low COI, the adjusted IRR for asthma was 0.87 (95% CI, 0.75-1.00) for high COI at birth and 0.83 (95% CI, 0.71-0.98) for very high COI at birth. These associations appeared to be attributable to the health and environmental and the social and economic domains of the COI. The SVI during early life was not significantly associated with asthma incidence. For example, compared with a very high SVI, the adjusted IRR for asthma was 0.88 (95% CI, 0.75-1.02) for low SVI at birth and 0.89 (95% CI, 0.76-1.03) for very low SVI at birth.ConclusionsIn this cohort study, high and very high neighborhood opportunity during early life compared with very low neighborhood opportunity were associated with lower childhood asthma incidence. These findings suggest the need for future studies examining whether investing in health and environmental or social and economic resources in early life would promote health equity in pediatric asthma.

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“… 4 Existing research has confirmed the theory of the fetal origin of asthma; that is, the intrauterine environment affects the growth and development of the fetus and modulates susceptibility to asthma. Many studies have investigated the correlation between parental occupational exposure, 5 pregnancy obesity, 6 maternal smoking in pregnancy 7 and preterm birth 8 with asthma, but current studies on the effect of birth weight on asthma have yielded inconsistent results. 9–11 Birth weight is an important indicator of intrauterine growth at birth.…”

Section: Introductionmentioning

confidence: 99%

Relationship Between Birth Weight and Asthma Diagnosis: A Cross-Sectional Survey Study Based on the National Survey of Children’s Health in the U.S.

Ni,

Li,

Zhang

et al. 2023

BMJ Open

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ObjectiveTo assess the association between birth weight and childhood asthma risk using data from the 2019–2020 National Survey of Children’s Health database.DesignCross-sectional study.SettingThe USA.PatientsA representative cohort of American children.ExposureThe exposure of this study was birth weight regardless of gestational age. Birth weight was divided into three groups: <1500 g, 1500–2500 g and >2500 g.Main outcome measuresPrimary outcomes were parent-reported diagnosis of asthma.MethodThe Rao-Scott χ2test was used to compare the groups. The main analyses examined the association between birth weight and parent-report asthma in children using univariable and multivariable logistic models adjusting for preterm birth, age, sex, race, family poverty, health insurance, smoking, maternal age. Subgroup analysis was performed based on interaction test.ResultsA total of 60 172 children aged 3–17 years were enrolled in this study; of these, 5202 (~8.6%) had asthma. Children with asthma were more likely to be born preterm, with low birth weight (LBW) or very LBW (VLBW). The incidence of asthma was the highest in VLBW children at 20.9% and showed a downward trend with an increase in birth weight class, with rates of 10.7% and 8.1% in the LBW and normal birthweight groups, respectively. Children with VLBW (OR 1.97; 95% CI 1.29 to 3.01) had higher odds of developing asthma in the adjusted analysis model. However, VLBW was only shown to be a risk factor for asthma among Hispanics, black/African-Americans and children between the ages of 6 and 12 years, demonstrating racial and age disparities.ConclusionsVLBW increases the risk of childhood asthma; however, racial and age disparities are evident.

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Prepregnancy body mass index and risk of childhood asthma

Cited by 8 publications

References 36 publications

Maternal obesity and childhood asthma risk: Exploring mediating pathways

Maternal obesity and childhood asthma risk: Exploring mediating pathways

Neighborhood Opportunity and Vulnerability and Incident Asthma Among Children

Relationship Between Birth Weight and Asthma Diagnosis: A Cross-Sectional Survey Study Based on the National Survey of Children’s Health in the U.S.

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