Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
Pediatr Pulmonol. 2023 Jan;58(1):35-45. doi: 10.1002/ppul.26153. Epub 2022 Oct 11.
Impaired lung function in early infancy is associated with later wheeze and asthma, while fetal thoracic circumference (TC) predicts severity of neonatal lung hypoplasia. Exploring fetal origins of lung function in infancy, we aimed to determine if fetal TC in mid-pregnancy was associated with infant lung function.
From the prospective Scandinavian general population-based PreventADALL mother-child birth cohort, all 851 3-month-old infants with tidal flow-volume measurements in the awake state and ultrasound fetal size measures at 18 (min-max 16-22) weeks gestational age were included. Associations between fetal TC and time to peak tidal expiratory flow to expiratory time (t /t ) were analyzed in linear regression models. To account for gestational age variation, we adjusted TC for simultaneously measured general fetal size, by head circumference (TC/HC), abdominal circumference (TC/AC), and femur length (TC/FL). Multivariable models were adjusted for maternal age, maternal asthma, pre-pregnancy body mass index, parity, nicotine exposure in utero, and infant sex.
The infants (47.8% girls) were born at mean (SD) gestational age of 40.2 (1.30) weeks. The mean (SD) t /t was 0.39 (0.08). The mean (SD) TC/HC was 0.75 (0.04), TC/AC 0.87 (0.04), and TC/FL 4.17 (0.26), respectively. Neither TC/HC nor TC/AC were associated with infant t /t while a week inverse association was observed between TC/FL and t /t ( = -0.03, 95% confidence interval [-0.05, -0.007], p = 0.01).
Mid-pregnancy fetal TC adjusted for fetal head or abdominal size was not associated with t /t in healthy, awake 3-month-old infants, while a weak association was observed adjusting for fetal femur length.
婴儿早期肺功能受损与后期喘息和哮喘有关，而胎儿胸围（TC）可预测新生儿肺发育不全的严重程度。为了探索婴儿期肺功能的胎儿起源，我们旨在确定妊娠中期胎儿 TC 是否与婴儿肺功能有关。
来自前瞻性斯堪的纳维亚一般人群为基础的 PreventADALL 母婴出生队列，所有 851 名 3 个月大的婴儿在清醒状态下进行潮气量流量测量，并在 18 周（最小-最大 16-22 周）妊娠时进行超声胎儿大小测量，均包括在内。在线性回归模型中分析了胎儿 TC 与呼气时间至峰值潮气流速时间（t / t ）之间的关系。为了考虑到胎龄的变化，我们通过头围（TC/HC）、腹围（TC/AC）和股骨长度（TC/FL）调整了同时测量的一般胎儿大小，从而调整了 TC。多变量模型调整了母亲年龄、母亲哮喘、孕前体重指数、产次、宫内尼古丁暴露和婴儿性别。
婴儿（47.8%为女孩）出生时的平均（SD）胎龄为 40.2（1.30）周。平均（SD）t / t 为 0.39（0.08）。TC/HC 的平均值（SD）分别为 0.75（0.04）、TC/AC 为 0.87（0.04），TC/FL 为 4.17（0.26）。TC/HC 和 TC/AC 均与婴儿 t / t 无关，而 TC/FL 与 t / t 呈负相关（β = -0.03，95%置信区间[-0.05，-0.007]，p = 0.01）。
妊娠中期胎儿 TC 经胎儿头部或腹部大小调整后，与健康、清醒 3 个月大的婴儿的 t / t 无关，而经胎儿股骨长度调整后，两者呈弱相关。
