Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Clin Exp Allergy. 2012 Oct;42(10):1430-47. doi: 10.1111/j.1365-2222.2012.03997.x.
Early genetic and environmental factors have been discussed as potential causes for the high prevalence of asthma and allergic disease in the western world, and knowledge on fetal growth and its consequence on future health and disease development is emerging.
This review article is an attempt to summarize research on fetal growth and risk of asthma and allergic disease. Current knowledge and novel findings will be reviewed and open research questions identified, to give basic scientists, immunologists and clinicians an overview of an emerging research field.
PubMed-search on pre-defined terms and cross-references.
Several studies have shown a correlation between low birth weight and/or gestational age and asthma and high birth weight and/or gestational age and atopy. The exact mechanism is not yet clear but both environmental and genetic factors seem to contribute to fetal growth. Some of these factors are confounders that can be adjusted for, and twin studies have been very helpful in this context. Suggested mechanisms behind fetal growth are often linked to the feto-maternal circulation, including the development of placenta and umbilical cord. However, the causal link between fetal growth restriction and subsequent asthma and allergic disease remains unexplained. New research regarding the catch-up growth following growth restriction has posited an alternative theory that diseases later on in life result from rapid catch-up growth rather than intrauterine growth restriction per se. Several studies have found a correlation between a rapid weight gain after birth and development of asthma or wheezing in childhood.
Asthma and allergic disease are multifactorial. Several mechanisms seem to influence their development. Additional studies are needed before we fully understand the causal links between fetal growth and development of asthma and allergic diseases.
早期的遗传和环境因素被认为是导致西方世界哮喘和过敏性疾病高发的潜在原因，而关于胎儿生长及其对未来健康和疾病发展的影响的知识正在不断涌现。
本文旨在总结胎儿生长与哮喘和过敏性疾病风险的相关研究。本文将综述当前的知识和新发现，并确定开放性的研究问题，以期为基础科学家、免疫学家和临床医生提供一个新兴研究领域的概述。
通过预定义的术语和交叉引用在 PubMed 上进行搜索。
多项研究表明，低出生体重和/或胎龄与哮喘以及高出生体重和/或胎龄与特应性之间存在相关性。确切的机制尚不清楚，但环境和遗传因素似乎都对胎儿生长有影响。其中一些因素是混杂因素，可以进行调整，双胞胎研究在这方面非常有帮助。胎儿生长背后的一些机制与胎-母循环有关，包括胎盘和脐带的发育。然而，胎儿生长受限与随后的哮喘和过敏性疾病之间的因果关系仍未得到解释。关于生长受限后追赶生长的新研究提出了一种替代理论，即生命后期的疾病是由快速追赶生长而不是宫内生长受限本身引起的。多项研究发现，出生后体重快速增加与儿童时期哮喘或喘息的发展之间存在相关性。
哮喘和过敏性疾病是多因素的。有几个机制似乎会影响它们的发展。在我们完全了解胎儿生长与哮喘和过敏性疾病发展之间的因果关系之前，还需要开展更多的研究。
