Relationship between fetal growth and the development of asthma and atopy in childhood

Abstract

Background-A study was undertaken to investigate the relationship between birth anthropometric measures and the subsequent development of asthma, airway hyperresponsiveness, and atopy in later childhood. Methods-A longitudinal study was performed on 734 subjects (71%) from a cohort of children born in Dunedin, New Zealand in 1972-73. The birth anthropometric measures were available from hospital records and the main outcome measures of reported asthma, skin prick tests, and methacholine hyperresponsiveness were measured at the age of 13 years, while the serum total IgE was measured at 11 years. Results-After adjustment for other factors, infants with a larger head circumference at birth tended to have higher serum total IgE at 11 years of age (p = 0.02) but IgE was not associated significantly with birth length or birth weight. The adjusted odds ratio for raised serum IgE (>150 IU/ ml) in infants with a head circumference of 37 cm or more was 3.4 (95% CI 1.4 to 7.9). In contrast, recent asthma symptoms were positively associated with birth length (p = 0.04) but not with head circumference. The adjusted odds ratio for asthma in the previous two years in infants with a birth length of 56 cm or more was 6.4 (95% CI 2.0 to 19.8). Infants with a birth weight of less than 3.0 kg had an odds ratio for reported asthma of 0.2 (95% CI 0.0-0.6). There were no significant associations of any of the birth parameters with skin prick positivity, reported hay fever, or eczema. Conclusions-These results suggest that increased fetal growth is related to an increased risk of asthma and atopy in childhood. The precision of the findings is limited by the small numbers in the extreme categories of each birth parameter, but the results are consistent with intrauterine programming of the developing respiratory and immune systems. (Thorax 1999;54:905-910)

Higher maternal dietary protein intake in late pregnancy is associated with a lower infant ponderal index at birth

“…The anthropometric indices were calculated as follows: ponderal index ¼ birth weight (kg)/crown-to-heel length (m 3 ); relative head circumference ¼ head circumference (cm) Â 100/ponderal index (Leadbitter et al, 1999); placental ratio ¼ placental weight (g) Â 100/birth weight (g) ; head circumference-to-birth length index ¼ head circumference (cm) Â 10/crown-to-heel length (cm) (Hagstrom et al, 1998). Ponderal index is an indicator of infant fatness and relative head circumference is an indicator of head size relative to the overall size of the infant (Leadbitter et al, 1999). Placental ratio is an indicator of possible antenatal hypoxemia (Godfrey et al, 1991), and the head circumference-to-birth length ratio has been used as an index of brain growth relative to linear growth.…”

Low-Normal Gestational Age as a Predictor of Asthma at 6 Years of Age

“…Although it is well established that prematurity is a major risk factor for the development of chronic lung disease, as a result of bronchopulmonary dysplasia, 1,2 and that extremely premature infants more frequently demonstrate persistent airway hyperresponsiveness in early childhood, 3 the influence of less extreme prematurity on the development of asthma among otherwise healthy children remains unresolved. Both low birth weight and prematurity were directly associated with the development of wheeze or asthma in several studies, 4-7 whereas other studies either failed to demonstrate an association [8][9][10][11] or demonstrated inverse relationships. 12 Although several of those studies were prospective, 6,8 most of the studies that demonstrated important effects included very premature infants (Ͻ36 weeks of gestation) in their analyses, making it difficult to separate the effects of prematurity from those associated with mechanical ventilation and respiratory distress syndrome.…”

Umbilical cord trace elements and minerals and risk of early childhood wheezing and eczema

“…Associations between anthropometry at birth and wheezing, asthma, eczema and raised Immunoglobulin (Ig)E [1][2][3][4][5][6] have led to conjecture that rates of foetal growth, and by implication foetal nutrition, might influence the inception of these conditions through "programming" of the foetal lung and immune development [7]. Whilst little is known about which specific nutrients might be involved, the antioxidant trace element selenium is of particular interest because it is thought to play an important role in lung development in animals [8].…”