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Maternal overweight before pregnancy and asthma in offspring followed for 8 years

International Journal of Obesity volume 34, pages 606–613 (2010)Cite this article

Abstract

Objective:

The aim of this study was to investigate the association between maternal overweight before pregnancy and offspring asthma in an ongoing birth cohort study. Maternal overweight may affect the pulmonary and immunological development of the fetus in utero because of the increased levels of inflammatory factors associated with being overweight and thereby increase the asthma risk in childhood.

Design:

Birth cohort study with follow-up until 8 years of age.

Subjects:

The study population included 3963 children and their mothers who participated in the Prevention and Incidence of Asthma and Mite Allergy study.

Measurements:

Maternal overweight before pregnancy was defined as a body mass index (BMI) above 25 kg m−2. Data on wheeze, dyspnea and prescription of inhaled corticosteroids of the child were reported yearly by the parents in a questionnaire. Sensitization to inhalant allergens and bronchial hyperresponsiveness (BHR) were determined at 8 years. Effect modification by predisposition for asthma in the child was tested. Data were analyzed by logistic regression and generalized estimating equations analyses.

Results:

At 8 years, 14.4% (n=571) of the children had asthma. In total, 20.9% (n=830) of the mothers were overweight before pregnancy. In children predisposed for asthma (n=1058), maternal overweight before pregnancy was associated with an increased risk of asthma in the child at 8 years (OR=1.52, 95% CI: 1.05–2.18) after adjustment for confounding factors, birth weight and the child's BMI. No association was observed in children without a predisposition (OR=0.86, 95% CI: 0.60–1.23). There was no association with sensitization or BHR.

Conclusion:

Children with a predisposition for asthma may have a higher risk to develop asthma during childhood when their mothers are overweight before pregnancy, irrespective of the child's BMI.

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References

  1. Devereux G . The increase in the prevalence of asthma and allergy: food for thought. Nat Rev Immunol 2006; 6: 869–874.

    Article  CAS  Google Scholar 

  2. Pattenden S, Antova T, Neuberger M, Nikiforov B, De Sario M, Grize L et al. Parental smoking and children's respiratory health: independent effects of prenatal and postnatal exposure. Tob Control 2006; 15: 294–301.

    Article  Google Scholar 

  3. Warner JA, Jones CA, Williams TJ, Warner JO . Maternal programming in asthma and allergy. Clin Exp Allergy 1998; 28 (Suppl 5): 35–38; discussion 50-1.

    Article  Google Scholar 

  4. Visser M, Bouter LM, McQuillan GM, Wener MH, Harris TB . Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282: 2131–2135.

    Article  CAS  Google Scholar 

  5. Kershaw EE, Flier JS . Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004; 89: 2548–2556.

    Article  CAS  Google Scholar 

  6. Hendler I, Blackwell SC, Mehta SH, Whitty JE, Russell E, Sorokin Y et al. The levels of leptin, adiponectin, and resistin in normal weight, overweight, and obese pregnant women with and without preeclampsia. Am J Obstet Gynecol 2005; 193: 979–983.

    Article  CAS  Google Scholar 

  7. Challier JC, Basu S, Bintein T, Minium J, Hotmire K, Catalano PM et al. Obesity in pregnancy stimulates macrophage accumulation and inflammation in the placenta. Placenta 2008; 29: 274–281.

    Article  CAS  Google Scholar 

  8. Reichman NE, Nepomnyaschy L . Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years. Matern Child Health J 2008; 12: 725–733.

    Article  Google Scholar 

  9. Scholtens S, Wijga AH, Seidell JC, Brunekreef B, de Jongste JC, Gehring U et al. Overweight and changes in weight status during childhood in relation to asthma symptoms at 8 years of age. J Allergy Clin Immunol 2009; 123 (6): 1312–1318.

    Article  Google Scholar 

  10. Brunekreef B, Smit J, de Jongste J, Neijens H, Gerritsen J, Postma D et al. The prevention and incidence of asthma and mite allergy (PIAMA) birth cohort study: design and first results. Pediatr Allergy Immunol 2002; 13 (Suppl 15): 55–60.

    Article  Google Scholar 

  11. Lakwijk N, Van Strien RT, Doekes G, Brunekreef B, Gerritsen J . Validation of a screening questionnaire for atopy with serum IgE tests in a population of pregnant Dutch women. Clin Exp Allergy 1998; 28: 454–458.

    Article  CAS  Google Scholar 

  12. Burney PG, Luczynska C, Chinn S, Jarvis D . The European Community Respiratory Health Survey. Eur Respir J 1994; 7: 954–960.

    Article  CAS  Google Scholar 

  13. Fredriks AM, van Buuren S, Burgmeijer RJ, Meulmeester JF, Beuker RJ, Brugman E et al. Continuing positive secular growth change in the Netherlands 1955–1997. Pediatr Res 2000; 47: 316–323.

    Article  CAS  Google Scholar 

  14. Rubin DB . Multiple Imputation for Nonresponse in Surveys. New York: John Wiley and Sons, 1987.

    Book  Google Scholar 

  15. Schafer JL . Analysis of Incomplete Multivariate Data. London: Chapman & Hall, 1997.

    Book  Google Scholar 

  16. Klebanoff MA, Cole SR . Use of multiple imputation in the epidemiologic literature. Am J Epidemiol 2008; 168: 355–357.

    Article  Google Scholar 

  17. van Buuren S, Oudshoorn K . MICE: Multivariate Imputation by Chained Equations. R package version 1.15 2005, http://webinter.nl.net/users/S.van.Buuren/mi/hmtl/mice.htm.

  18. Visscher TL, Viet AL, Kroesbergen IH, Seidell JC . Underreporting of BMI in adults and its effect on obesity prevalence estimations in the period 1998–2001. Obesity (Silver Spring) 2006; 14: 2054–2063.

    Article  Google Scholar 

  19. Beuther DA, Sutherland ER . Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med 2007; 175: 661–666.

    Article  Google Scholar 

  20. Flaherman V, Rutherford GW . A meta-analysis of the effect of high weight on asthma. Arch Dis Child 2006; 91: 334–339.

    Article  CAS  Google Scholar 

  21. Gold DR, Damokosh AI, Dockery DW, Berkey CS . Body-mass index as a predictor of incident asthma in a prospective cohort of children. Pediatr Pulmonol 2003; 36: 514–521.

    Article  Google Scholar 

  22. Scholtens S, Brunekreef B, Visscher TL, Smit HA, Kerkhof M, de Jongste JC et al. Reported versus measured body weight and height of 4-year-old children and the prevalence of overweight. Eur J Public Health 2007; 17: 369–374.

    Article  Google Scholar 

  23. Pietrobelli A, Faith MS, Allison DB, Gallagher D, Chiumello G, Heymsfield SB . Body mass index as a measure of adiposity among children and adolescents: a validation study. J Pediatr 1998; 132: 204–210.

    Article  CAS  Google Scholar 

  24. von Mutius E, Schwartz J, Neas LM, Dockery D, Weiss ST . Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III. Thorax 2001; 56: 835–838.

    Article  CAS  Google Scholar 

  25. Mai XM, Nilsson L, Axelson O, Bråbäck L, Sandin A, Kjellman NI et al. High body mass index, asthma and allergy in Swedish schoolchildren participating in the International Study of Asthma and Allergies in Childhood: Phase II. Acta Paediatr 2003; 92: 1144–1148.

    Article  CAS  Google Scholar 

  26. Willers SM, Devereux G, Craig LC, McNeill G, Wijga AH, Abou El-Magd W et al. Maternal food consumption during pregnancy and asthma, respiratory and atopic symptoms in 5-year-old children. Thorax 2007; 62: 773–779.

    Article  CAS  Google Scholar 

  27. Litonjua AA, Rifas-Shiman SL, Ly NP, Tantisira KG, Rich-Edwards JW, Camargo Jr CA et al. Maternal antioxidant intake in pregnancy and wheezing illnesses in children at 2 y of age. Am J Clin Nutr 2006; 84: 903–911.

    Article  CAS  Google Scholar 

  28. Devereux G, Litonjua AA, Turner SW, Craig LC, McNeill G, Martindale S et al. Maternal vitamin D intake during pregnancy and early childhood wheezing. Am J Clin Nutr 2007; 85: 853–859.

    Article  CAS  Google Scholar 

  29. King JC . Maternal obesity, metabolism, and pregnancy outcomes. Annu Rev Nutr 2006; 26: 271–291.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the Netherlands Organisation for Health Research and Development, the Netherlands Asthma Foundation, the Netherlands Ministry of Health, Welfare and Sport and Numico Research, the Netherlands. The funding source had no involvement in the study design, in the collection of the data, data analysis, interpretation of the data, writing the report and in the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands

    S Scholtens, B Brunekreef & M Oldenwening

  2. Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

    S Scholtens, A H Wijga & H A Smit

  3. Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands

    B Brunekreef & H A Smit

  4. Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    M Kerkhof

  5. Department of Pulmonology, University Medical Centre Groningen, University of Groningen, The Netherlands

    D S Postma

  6. Division of Respiratory Medicine, Department of Pediatrics, Erasmus MC—Sophia, Rotterdam, The Netherlands

    J C de Jongste

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  1. S Scholtens
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  2. A H Wijga
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  7. J C de Jongste
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  8. H A Smit
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Correspondence to S Scholtens.

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Scholtens, S., Wijga, A., Brunekreef, B. et al. Maternal overweight before pregnancy and asthma in offspring followed for 8 years. Int J Obes 34, 606–613 (2010). https://doi.org/10.1038/ijo.2009.194

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