Fetal and Infant Growth and Asthma Symptoms in Preschool Children: The Generation R Study

• Published in: American journal of respiratory and critical care medicine Vol. 185; no. 7; pp. 731 - 737
• Main Authors: SONNENSCHEIN-VAN DER VOORT, Agnes M. M, JADDOE, Vincent W. V, RAAT, Hein, MOLL, Henriette A, HOFMAN, Albert, DE JONGSTE, Johan C, DUIJTS, Liesbeth
• Format: Journal Article
• Language: English
• Published: New York, NY American Thoracic Society 01-04-2012
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Asthma; Asthma - epidemiology; Asthma - etiology; Biological and medical sciences; Birth weight; Birth Weight - physiology; Child Development - physiology; Child, Preschool; Children & youth; Cohort analysis; Eczema; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Female; Fetal Development - physiology; Gestational Age; Humans; Infant; Infant, Newborn; Intensive care medicine; Male; Medical sciences; Midwifery; Mothers; Preschool children; Prospective Studies; Questionnaires; Risk Factors; Young Adult; Human; Allergy; Immunopathology; Lung disease; Pediatrics; Skin disease; Intensive care; Respiratory disease; Infant; Wheezing; Asthma; Dyspnea; Cohort study; Eczema; cohort studies; Bronchus disease; Obstructive pulmonary disease; Child; Resuscitation
• ISSN: 1073-449X; 1535-4970
• DOI: 10.1164/rccm.201107-1266OC

Low birth weight is associated with an increased risk of wheezing in childhood.
We examined the associations of longitudinally measured fetal and infant growth patterns with the risks of asthma symptoms in preschool children.
This study was embedded in a population-based prospective cohort study among 5,125 children. Second- and third-trimester fetal growth characteristics (head circumference, femur length, abdominal circumference, and weight) were estimated by repeated ultrasounds. Infant growth (head circumference, length, and weight) was measured at birth and at the ages of 3, 6, and 12 months. Parental report of asthma symptoms until the age of 4 years was yearly obtained by questionnaires.
Both fetal restricted and accelerated growth, defined as a negative or positive change of more than 0.67 standard deviation score, were not associated with asthma symptoms until the age of 4 years. Accelerated weight gain from birth to 3 months following normal fetal growth was associated with increased risks of asthma symptoms (overall odds ratio for wheezing: 1.44 [95% confidence interval: 1.22, 1.70]; shortness of breath: 1.32 [1.12, 1.56]; dry cough: 1.16 [1.01, 1.34]; persistent phlegm: 1.30 [1.07, 1.58]), but not with eczema (0.95 [0.80, 1.14]). These associations were independent of other fetal growth patterns and tended to be stronger for children of atopic mothers than for children of nonatopic mothers.
Weight-gain acceleration in early infancy was associated with increased risks of asthma symptoms in preschool children, independent of fetal growth. Early infancy might be a critical period for the development of asthma.