Centre for Research in Environmental Epidemiology, Barcelona, Spain.
Paediatr Perinat Epidemiol. 2013 Jan;27(1):100-8. doi: 10.1111/ppe.12013.
Maternal prepregnancy obesity has been linked to the offspring's risk for subsequent asthma. We determined whether maternal obesity is associated with increased risk of wheezing phenotypes early in life.
We used data on 1107 mother-child pairs from two birth cohorts from the INMA-INfancia y Medio Ambiente project. Maternal height was measured and prepregnancy weight self-reported at enrolment (on average at 13.7 ± 2 weeks of gestation). Maternal prepregnancy body mass index was categorised as underweight, normal, overweight and obese according to WHO recommendations. Information on child's wheezing was obtained through questionnaires up to the age of 14 (± 1) months. Wheezing was classified as infrequent (<4 reported wheezing episodes) or frequent (≥ 4 episodes). Weight and length of infants were measured by trained study staff at 14.6 (± 1) months of age and weight-for-length z-scores computed.
Although maternal obesity did not increase the risk of the child to have any or infrequent wheezing, children of obese mothers were more likely to have frequent wheezing than children of normal-weight mothers (11.8% vs. 3.8%; P = 0.002). In fully adjusted multinomial logistic regression models, including infants' weight-for-length z-scores and other covariates, maternal prepregnancy obesity was associated with increased risk of frequent [adjusted relative risk (RR) 4.18, 95% confidence interval (CI) 1.55, 11.3] but not infrequent (RR 1.05 [95% CI 0.55, 2.01]) wheezing in their children.
Maternal prepregnancy obesity is independently associated with an increased risk of frequent wheezing in the infant by the age of 14 months. These findings add evidence on the potential effects of in utero exposures on asthma-related phenotypes.
母体孕前肥胖与后代日后患哮喘的风险有关。我们确定了母体肥胖是否与生命早期喘息表型的风险增加有关。
我们使用了来自 INMA-INfancia y Medio Ambiente 项目的两个出生队列的 1107 对母婴数据。在登记时(平均在妊娠 13.7±2 周)测量了母亲的身高并自我报告了孕前体重。根据世卫组织的建议,将母亲的孕前体重指数分为体重不足、正常、超重和肥胖。通过在 14(±1)月龄时的问卷调查获得儿童喘息的信息。将喘息分为不频繁(<4 次报告的喘息发作)或频繁(≥4 次发作)。在 14.6(±1)月龄时,由经过培训的研究人员测量婴儿的体重和长度,并计算体重长度 z 分数。
虽然母体肥胖并没有增加孩子出现任何喘息或不频繁喘息的风险,但与正常体重母亲的孩子相比,肥胖母亲的孩子更有可能出现频繁喘息(11.8%比 3.8%;P=0.002)。在完全调整的多变量逻辑回归模型中,包括婴儿的体重长度 z 分数和其他协变量,母亲的孕前肥胖与频繁喘息的风险增加相关(调整后的相对风险 4.18,95%置信区间 1.55,11.3),但与不频繁喘息无关(RR 1.05[95%CI 0.55,2.01])。
母体孕前肥胖与 14 月龄婴儿频繁喘息的风险独立相关。这些发现为宫内暴露对与哮喘相关表型的潜在影响提供了证据。