Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK.
J Epidemiol Community Health. 2012 Sep;66(9):809-14. doi: 10.1136/jech.2011.133777. Epub 2011 Aug 15.
The high prevalence of children's asthma symptoms, worldwide, is unexplained. We examined the relation between maternal pre-pregnancy weight and body mass index (BMI), and asthma symptoms in adolescents.
Data from 6945 adolescents born within the Northern Finland Birth Cohort 1986 were used. Prospective antenatal and birth outcome data, including maternal pre-pregnancy weight and BMI, and asthma symptoms in adolescent offspring at age 15-16 years, were employed. Logistic regression analyses were performed to examine the associations between relevant prenatal factors and asthma symptoms during adolescence.
Current wheeze (within the past year) was reported by 10.6% of adolescents, and physician-diagnosed asthma by 6.0%. High maternal pre-pregnancy BMI was a significant predictor of wheeze in the adolescents (increase per kilogram per square metre unit; 2.7%, 95% CI 0.9 to 4.4 for ever wheeze; 3.5%, 95% CI 1.3 to 5.8 for current wheeze), and adjusting for potential confounders further increased the risk (2.8%, 95% CI 0.5 to 5.1; 4.7%, 95% CI 1.9 to 7.7, respectively). High maternal pre-pregnancy weight, in the top tertile, also significantly increased the odds of current wheeze in the adolescent by 20% (95% CI 4 to 39), and adjusting for potential confounders further increased the risk (OR=1.52, 95% CI 1.19 to 1.95). Results were similar for current asthma. Furthermore, these significant associations were observed only among adolescents without parental history of atopy but not among those with parental history of atopy.
The association demonstrated here between maternal pre-pregnancy overweight and obesity, and asthma symptoms in adolescents suggests that increase in asthma may be partly related to the rapid rise in obesity in recent years.
儿童哮喘症状在全球范围内高发,但原因尚未明确。我们研究了母亲孕前体重和体重指数(BMI)与青少年哮喘症状之间的关系。
本研究使用了 1986 年出生于芬兰北部出生队列的 6945 名青少年的数据。前瞻性的产前和出生结局数据,包括母亲孕前体重和 BMI,以及青少年在 15-16 岁时的哮喘症状,都被用于本研究。采用逻辑回归分析来研究相关产前因素与青少年时期哮喘症状之间的关系。
有 10.6%的青少年报告有当前喘息(过去 1 年),6.0%的青少年被诊断为哮喘。母亲孕前 BMI 较高是青少年喘息的显著预测因素(每增加一公斤/平方米单位,终身喘息的风险增加 2.7%,95%CI 0.9 至 4.4;当前喘息的风险增加 3.5%,95%CI 1.3 至 5.8),调整潜在混杂因素后,风险进一步增加(分别为 2.8%,95%CI 0.5 至 5.1;4.7%,95%CI 1.9 至 7.7)。母亲孕前体重处于最高三分位时,青少年当前喘息的风险也显著增加 20%(95%CI 4 至 39),调整潜在混杂因素后,风险进一步增加(OR=1.52,95%CI 1.19 至 1.95)。当前哮喘的结果也类似。此外,这些显著关联仅见于无特应性父母病史的青少年中,而不存在于有特应性父母病史的青少年中。
本研究表明,母亲孕前超重和肥胖与青少年哮喘症状之间存在关联,这表明近年来肥胖的迅速增加可能与哮喘的增加部分相关。