Dumas O, Varraso R, Gillman M W, Field A E, Camargo C A
Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Allergy. 2016 Sep;71(9):1295-304. doi: 10.1111/all.12876. Epub 2016 Apr 13.
Sparse data are available on the relationship between prenatal exposures and asthma during later childhood. In a longitudinal study of adolescents and their mothers, we examined the association of (i) maternal prepregnancy body mass index (BMI) and (ii) gestational weight gain (GWG), with incidence of allergic and nonallergic asthma in offspring.
Analyses were conducted using data from 12 963 children aged 9-14 years at enrolment in the Growing Up Today Study, and their mothers, who are participants in the Nurses' Health Study II. Physician-diagnosed asthma and allergies were assessed by questionnaires sent regularly to participants and their mothers. Logistic regression was used to evaluate associations of maternal BMI and GWG with offspring asthma, overall and by subtype.
Physician-diagnosed asthma during childhood or adolescence was reported by 2694 children (21%). Maternal prepregnancy overweight (OR: 1.19, 95% CI: 1.03-1.38) and obesity (1.34, 1.08-1.68) were associated with offspring asthma. In asthma subtype analyses, the association was seen only for asthma onset before age 12 years. Moreover, the association of maternal obesity with nonallergic asthma was observed in boys (2.39, 1.40-4.09) and not in girls (0.96, 0.50-1.85; Pinteraction = 0.03); the opposite pattern was suggested for allergic asthma. With regard to GWG, an association was suggested between gains of <15 lb and higher risk of offspring asthma (1.28, 0.98-1.66), without clear allergy- or sex-related patterns.
The relation of several prenatal factors to risk of childhood asthma supports the early origins hypothesis for asthma. The observed allergy- and sex-specific patterns suggest multiple etiologic pathways.
关于产前暴露与儿童后期哮喘之间关系的数据稀少。在一项针对青少年及其母亲的纵向研究中，我们考察了（i）母亲孕前体重指数（BMI）和（ii）孕期体重增加（GWG）与后代过敏性和非过敏性哮喘发病率之间的关联。
使用来自“今日成长研究”中12963名9至14岁儿童及其母亲的数据进行分析，这些母亲是“护士健康研究II”的参与者。通过定期发送给参与者及其母亲的问卷来评估医生诊断的哮喘和过敏情况。使用逻辑回归来评估母亲BMI和GWG与后代哮喘的总体关联以及按亚型的关联。
2694名儿童（21%）报告在儿童期或青少年期被医生诊断为哮喘。母亲孕前超重（比值比：1.19，95%置信区间：1.03 - 1.38）和肥胖（1.34，1.08 - 1.68）与后代哮喘相关。在哮喘亚型分析中，这种关联仅在12岁前发病的哮喘中可见。此外，在男孩中观察到母亲肥胖与非过敏性哮喘相关（2.39，1.40 - 4.09），而在女孩中未观察到（0.96，0.50 - 1.85；交互作用P值 = 0.03）；过敏性哮喘则呈现相反模式。关于GWG，孕期体重增加<15磅与后代哮喘风险较高之间存在关联（1.28，0.98 - 1.66），且无明确的过敏或性别相关模式。
几种产前因素与儿童哮喘风险的关系支持了哮喘的早期起源假说。观察到的过敏和性别特异性模式提示了多种病因途径。
