Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Ariadne Labs, Boston, Massachusetts; Departments of Health Policy and Management and of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts.
Ann Allergy Asthma Immunol. 2022 Aug;129(2):199-204.e3. doi: 10.1016/j.anai.2022.04.032. Epub 2022 May 10.
Maternal obesity may affect offspring asthma and atopic disease risk by altering fetal immune system development. However, few studies evaluate gestational weight gain (GWG).
To evaluate relationships between maternal body mass index (BMI), GWG, and persistent wheeze, eczema, allergy, and asthma risk in offspring through middle childhood.
A total of 5939 children from Upstate KIDS, a population-based longitudinal cohort of children born in upstate New York (2008-2019) were included in the analysis. Persistent wheeze or asthma, eczema, and allergy were maternally reported at multiple study time points throughout early and middle childhood. Poisson regression models with robust SEs were used to estimate adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) for offspring atopic outcomes by maternal prepregnancy BMI and GWG.
Prepregnancy BMI was associated with increased risk of persistent wheeze by 3 years of age even after adjustments for maternal atopy (class I obesity: aRR, 1.58; 95% CI, 1.13-2.20; class II or III obesity: aRR, 1.69; 95% CI, 1.22-2.35). Associations with reported asthma in middle childhood did not reach statistical significance. Furthermore, no associations were found between prepregnancy BMI and atopic outcomes in either early or middle childhood. GWG was not associated with higher risk of early childhood persistent wheeze or middle childhood asthma.
Maternal prepregnancy BMI was associated with increased risk of offspring wheeze, whereas excessive GWG was generally not associated with childhood asthma or atopy.
母体肥胖可能通过改变胎儿免疫系统的发育而影响后代哮喘和特应性疾病的风险。然而，很少有研究评估妊娠体重增加（GWG）。
通过儿童中期评估母体体重指数（BMI）、GWG 与后代持续性喘息、湿疹、过敏和哮喘风险之间的关系。
共纳入来自纽约州北部儿童（Upstate KIDS）的 5939 名儿童，这是一个基于人群的纵向队列，研究对象为纽约州北部出生的儿童（2008-2019 年）。在儿童早期和中期的多个研究时间点，母亲通过报告评估持续性喘息或哮喘、湿疹和过敏。使用具有稳健标准误差的泊松回归模型，根据母亲孕前 BMI 和 GWG，估计后代特应性结局的调整风险比（aRR）和 95%置信区间（CI）。
即使在校正母亲特应性后，孕前 BMI 与 3 岁时持续性喘息的风险增加相关（I 类肥胖：aRR，1.58；95%CI，1.13-2.20；II 类或 III 类肥胖：aRR，1.69；95%CI，1.22-2.35）。与儿童中期报告的哮喘之间的关联没有达到统计学意义。此外，在儿童早期或中期，孕前 BMI 与特应性结局之间均无关联。GWG 与儿童早期持续性喘息或中期哮喘的高风险无关。
母亲孕前 BMI 与后代喘息风险增加相关，而 GWG 过多通常与儿童期哮喘或特应性无关。
