Longitudinal study of maternal body mass index, gestational weight gain, and offspring asthma

Abstract

Background

Sparse data are available on the relationship between prenatal exposures and asthma during later childhood. In a longitudinal study of adolescents and their mothers, we examined the association of (1) maternal pre-pregnancy body mass index (BMI) and (2) gestational weight gain (GWG), with incidence of allergic and non-allergic asthma in offspring.

Methods

Analyses were conducted using data from 12,963 children aged 9-14 years at enrollment in the Growing Up Today Study, and their mothers, who are participants in the Nurses' Health Study II. Physician-diagnosed asthma and allergies were assessed by questionnaires sent regularly to participants and their mothers. Logistic regression was used to evaluate associations of maternal BMI and GWG with offspring asthma, overall and by subtype.

Results

Physician-diagnosed asthma during childhood or adolescence was reported by 2,694 children (21%). Maternal pre-pregnancy overweight (OR: 1.19, 95% CI: 1.03-1.38) and obesity (1.34, 1.08-1.68) were associated with offspring asthma. In asthma subtype analyses, the association was seen only for asthma onset before age 12 years. Moreover, the association of maternal obesity with non-allergic asthma was observed in boys (2.39, 1.40-4.09) and not in girls (0.96, 0.50-1.85; P_interaction=0.03); the opposite pattern was suggested for allergic asthma. With regard to GWG, an association was suggested between gains of <15 lb and higher risk of offspring asthma (1.28, 0.98-1.66), without clear allergy- or sex-related patterns.

Conclusion

The relation of several prenatal factors to risk of childhood asthma supports the early origins hypothesis for asthma. The observed allergy- and sex-specific patterns suggest multiple etiologic pathways.

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