Rajappan Ashley, Pearce Anna, Inskip Hazel M, Baird Janis, Crozier Sarah R, Cooper Cyrus, Godfrey Keith M, Roberts Graham, Lucas Jane S A, Pike Katharine C
University College Medical School, University College London, London, UK.
Population, Policy and Practice Academic Programme, UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Pediatr Pulmonol. 2017 Oct;52(10):1291-1299. doi: 10.1002/ppul.23779. Epub 2017 Aug 16.
Maternal obesity is increasingly prevalent in many westernized countries. Many studies report associations between maternal obesity and childhood wheeze or asthma but few have considered maternal obesity in relation to respiratory infections or symptoms other than wheeze during infancy. This study assesses the relationship between maternal BMI and reported wheeze, cough and respiratory infections during the first year of life.
In 2799 mother-child pairs, we examined the relations between maternal pre-pregnancy BMI and pregnancy weight gain and reported offspring wheeze, prolonged cough, lower respiratory tract infection, croup, and ear infection before age 1 year, along with reported diarrhea or vomiting. Maternally reported paternal BMI was included in the models as a proxy for unmeasured confounding by shared familial factors.
Higher maternal BMI was associated with increased risks of offspring wheeze, prolonged cough and lower respiratory tract infection (relative risks (95%CI) per 5 kg/m 1.09 (1.05-1.13), 1.09 (1.03-1.14), and 1.13 (1.07-1.20), respectively). These associations remained after adjusting for maternally reported paternal BMI. No associations were found with croup, ear infection, or diarrhea or vomiting. Pregnancy weight gain was not associated with any of the offspring symptoms or illnesses.
Higher maternal BMI is associated with increased risk of wheeze, cough, and maternally reported lower respiratory tract infection in infancy. These associations were independent of maternally reported paternal BMI. These observations might be explained by intrauterine effects of maternal obesity upon respiratory or immune development.
在许多西方国家,孕产妇肥胖现象日益普遍。许多研究报告了孕产妇肥胖与儿童喘息或哮喘之间的关联,但很少有研究考虑孕产妇肥胖与婴儿期除喘息外的呼吸道感染或症状之间的关系。本研究评估了孕产妇体重指数(BMI)与1岁前报告的喘息、咳嗽和呼吸道感染之间的关系。
在2799对母婴中,我们研究了孕前孕产妇BMI与孕期体重增加之间的关系,并报告了1岁前后代的喘息、持续性咳嗽、下呼吸道感染、哮吼和耳部感染情况,以及腹泻或呕吐情况。模型中纳入了母亲报告的父亲BMI,以代表未测量的家族共同因素造成的混杂影响。
孕产妇BMI越高,后代喘息、持续性咳嗽和下呼吸道感染的风险增加(每5kg/m的相对风险(95%置信区间)分别为1.09(1.05 - 1.13)、1.09(1.03 - 1.14)和1.13(1.07 - 1.20))。在调整了母亲报告的父亲BMI后,这些关联仍然存在。未发现与哮吼、耳部感染或腹泻或呕吐有关联。孕期体重增加与任何后代症状或疾病均无关联。
孕产妇BMI较高与婴儿期喘息、咳嗽以及母亲报告的下呼吸道感染风险增加有关。这些关联独立于母亲报告的父亲BMI。这些观察结果可能由孕产妇肥胖对呼吸或免疫发育的宫内影响来解释。