Institute of Food Nutrition and Human Health, Massey University, Auckland, New Zealand.
Matern Child Health J. 2013 Jul;17(5):959-67. doi: 10.1007/s10995-012-1124-6.
To investigate the association of subcutaneous body fat levels in pregnant women with wheezing in their 18 month old infants. A prospective study of European and Polynesian volunteers (n = 369) recruited from northern New Zealand were visited in months 4 and 7 of pregnancy when height, weight, and triceps, biceps and costal skinfolds were measured, and questionnaires determining personal details administered; and again visited 18 months after birth when infants were measured and questions on infant feeding and wheeze administered. At 18 months 32 % of infants had wheezed in the past 12 months. Increased wheeze was associated with maternal asthma, eczema or allergy (p = 0.001); receiving family welfare payments (p = 0.010); and being Polynesian (p = 0.021); while exclusive breastfeeding to 2 months (p = 0.045) was associated with decreased wheeze. Individual month 4 and month 7 mean triceps, biceps and costal skinfolds were all greater in mothers of wheezers compared to nonwheezers, biceps and costal skinfolds significantly so (p = 0.002, p = 0.005 at month 7). The sum of these skinfolds at month 4, at month 7, and the difference between these sums, were all significantly associated with increased risk of infant wheeze at 18 months when considered alone (p = 0.037, p = 0.001 and p = 0.015) or in combination. Prevalence of infant wheeze was 22.7 % for mothers with lower quartile month 7 skinfolds, compared to 45.0 % for mothers with upper quartile. After adjusting for significant covariates the difference in skinfolds had the strongest association (p = 0.003) followed by sum at month 4 (p = 0.074 or 0.003 depending on whether Polynesian ethnicity was included in the model). The sum of skinfolds declined between month 4 and month 7 in 34 % of women. Prevalence of wheeze was 19.2 % where the difference in mothers' skinfolds between month 4 and month 7 decreased by 10 mm or more and 41.7 % where the difference increased by 10 mm or more. Mean month 4 weights, BMI and sum of skinfolds were below average in the latter group. As the sum of month 4 or month 7 maternal skinfolds increased the prevalence of infant wheeze increased. In addition as the change in skinfolds between month 4 and month 7 became more positive the prevalence of infant wheeze increased. This study suggests for the first time that changes in subcutaneous fat during pregnancy are associated with prevalence of infant wheeze.
研究孕妇皮下体脂水平与 18 个月大婴儿喘息之间的关联。本前瞻性研究招募了来自新西兰北部的欧洲和波利尼西亚志愿者（n=369），在妊娠 4 个月和 7 个月时测量身高、体重和三头肌、二头肌和肋部皮褶厚度，并进行了确定个人详细信息的问卷调查；在婴儿出生后 18 个月再次进行访问，测量婴儿并询问婴儿喂养和喘息情况。在 18 个月时，32%的婴儿在过去 12 个月中有过喘息。喘息增加与母亲哮喘、湿疹或过敏（p=0.001）、接受家庭福利金（p=0.010）和波利尼西亚人（p=0.021）有关；而 2 个月时的纯母乳喂养（p=0.045）与喘息减少有关。与非喘息组相比，喘息组的母亲在妊娠 4 个月和 7 个月时的平均三头肌、二头肌和肋部皮褶都更高，二头肌和肋部皮褶差异显著（p=0.002，p=0.005，在妊娠 7 个月时）。当单独考虑或组合考虑时，妊娠 4 个月时这些皮褶的总和、妊娠 7 个月时这些皮褶的总和以及这些总和之间的差异，都与 18 个月时婴儿喘息的风险增加显著相关（p=0.037，p=0.001 和 p=0.015）。在妊娠 7 个月时，第 7 个月时的皮褶量较低四分位数的母亲中婴儿喘息的患病率为 22.7%，而第 7 个月时皮褶量较高四分位数的母亲中婴儿喘息的患病率为 45.0%。在调整了显著协变量后，皮褶厚度的差异具有最强的关联（p=0.003），其次是妊娠 4 个月时的总和（p=0.074 或 0.003，具体取决于是否将波利尼西亚种族纳入模型）。在 34%的女性中，妊娠 4 个月至 7 个月之间，皮褶厚度总和下降。在母亲的皮褶厚度在妊娠 4 个月至 7 个月之间减少 10 毫米或更多的情况下，喘息的患病率为 19.2%，而在皮褶厚度增加 10 毫米或更多的情况下，喘息的患病率为 41.7%。在后者组中，妊娠 4 个月时的平均体重、BMI 和皮褶厚度总和低于平均值。随着妊娠 4 个月或 7 个月时母亲皮褶厚度总和的增加，婴儿喘息的患病率增加。此外，随着妊娠 4 个月至 7 个月之间皮褶厚度变化变得更加积极，婴儿喘息的患病率增加。本研究首次表明，妊娠期间皮下脂肪的变化与婴儿喘息的发生率有关。
