Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tenn.
J Allergy Clin Immunol Pract. 2024 Oct;12(10):2719-2729.e5. doi: 10.1016/j.jaip.2024.07.008. Epub 2024 Jul 17.
The contribution of prenatal anthropometric measures to the development of specific childhood asthma phenotypes is not known.
We aimed to evaluate associations between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and nonallergic asthma phenotypes in childhood.
Our study population included term, healthy infants in the middle Tennessee region of the United States. Prepregnancy BMI and GWG were ascertained from questionnaires administered during early infancy and categorized based on World Health Organization and Institute of Medicine recommendations, respectively. Allergic asthma was defined as 5-year current asthma and a positive skin test or specific IgE to aeroallergen(s). We used multivariable logistic regression models for asthma and multinomial logistic regression models for nonasthma, allergic asthma, and nonallergic asthma.
A total of 1266 children were included. At the 5-year follow-up, 194 (15.3%) had asthma; among them, 102 (52.6%) had allergic asthma. Both inadequate and excessive GWG, compared with adequate GWG, were associated with increased odds of asthma (inadequate: adjusted odds ratio [aOR]: 1.76 [95% confidence interval (CI): 1.03-2.98]; excessive: aOR: 1.70 [95% CI: 1.12-2.57]) and increased odds of allergic asthma compared with no asthma (inadequate: aOR: 3.49 [95% CI: 1.66-7.32]; excessive: aOR: 2.55 [95% CI: 1.34-4.85]). Prepregnancy BMI was not associated with asthma nor with asthma phenotypes.
Both inadequate and excessive GWG were associated with allergic asthma risk. These results support the benefits of optimal GWG during pregnancy on child health outcomes.
产前人体测量指标对特定儿童期哮喘表型的发展的贡献尚不清楚。
我们旨在评估妊娠前体重指数（BMI）和妊娠增重（GWG）与儿童期过敏性和非过敏性哮喘表型之间的关系。
我们的研究人群包括美国田纳西州中部地区的足月、健康婴儿。妊娠前 BMI 和 GWG 是通过在婴儿早期进行的问卷调查确定的，并分别根据世界卫生组织和医学研究所的建议进行分类。过敏性哮喘定义为 5 岁时当前哮喘和对过敏原的皮肤试验或特异性 IgE 阳性。我们使用多变量逻辑回归模型进行哮喘分析，使用多项逻辑回归模型进行非哮喘、过敏性哮喘和非过敏性哮喘分析。
共纳入 1266 名儿童。在 5 年随访时，有 194 名（15.3%）患有哮喘；其中，102 名（52.6%）患有过敏性哮喘。与适当 GWG 相比，GWG 不足和过多均与哮喘的发病风险增加相关（不足：调整后的优势比 [aOR]：1.76 [95%置信区间（CI）：1.03-2.98]；过多：aOR：1.70 [95% CI：1.12-2.57]），并且与无哮喘相比，患过敏性哮喘的风险增加（不足：aOR：3.49 [95% CI：1.66-7.32]；过多：aOR：2.55 [95% CI：1.34-4.85]）。妊娠前 BMI 与哮喘或哮喘表型均无关联。
GWG 不足和过多均与过敏性哮喘风险相关。这些结果支持妊娠期间最佳 GWG 对儿童健康结果的益处。
