The association between prenatal F-isoprostanes and child wheeze/asthma and modification by maternal race.

BACKGROUND

Childhood wheeze, asthma, and allergic rhinitis are common and likely have prenatal origins. Oxidative stress is associated with respiratory disease, but the association of oxidative stress during the prenatal period with development of respiratory and atopic disease in childhood, particularly beyond the infancy period, is unknown. This study aims to investigate associations between prenatal oxidative stress, measured by maternal urinary F-isoprostanes, and child respiratory outcomes, including effect modification by maternal race.

METHODS

We prospectively studied Black (n = 717) and White (n = 363) mother-child dyads. We measured F-isoprostanes in 2nd-trimester urine (ng/mg-creatinine). At approximately age 4, we obtained parent report of provider-diagnosed asthma (ever), current wheeze, current asthma (diagnosis, symptoms and/or medication), and current allergic rhinitis (current defined as previous 12 months). We used multivariable logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) per interquartile range (IQR) increase in F-isoprostane concentration, controlling for confounders. We examined modification by maternal race using interaction terms.

RESULTS

The prevalence of provider-diagnosed asthma and current wheeze, asthma and allergic rhinitis was 14%, 19%, 15%, and 24%, respectively. Median (IQR) Fisoprostane levels were 2.1 (1.6, 2.9) ng/mg-creatinine. Associations between prenatal F-isoprostanes and provider-diagnosed asthma, current wheeze, and current asthma were modified by maternal race. Results were strongest for current wheeze (aOR [95%CI]: 1.55 [1.16, 2.06] for White; 0.98 [0.78, 1.22] for Black; p-interaction = 0.01). We observed no association between Fisoprostanes and allergic rhinitis.

CONCLUSION

Prenatal urinary F-isoprostanes may be a marker associated with childhood wheeze/asthma in certain populations. Research is needed to understand underlying mechanisms and racial differences.