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Associations of postnatal growth with asthma and atopy: the PROBIT Study
Emma L Anderson1, Abigail Fraser, Richard M Martin
1MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK. emma.louise.anderson@bristol.ac.uk
Insights
Infant growth patterns show limited association with childhood atopy. Current height and weight are more strongly linked to atopic conditions, suggesting reverse causality or confounding factors influence this relationship.
Area of Science:
- Pediatric Allergy and Immunology
- Growth and Development Studies
- Epidemiology of Atopic Diseases
Background:
- Hypotheses suggest links between infant growth and atopic conditions like wheeze and asthma.
- Existing evidence supporting these associations is limited and inconsistent.
Purpose of the Study:
- To investigate the relationship between postnatal weight and length/height gain and atopic phenotypes in childhood.
- To determine if infant growth trajectories predict the development of allergies and asthma.
Main Methods:
- Prospective data collection of weight and length/height from birth to 6.5 years in 12,171 infants.
- Atopic phenotypes assessed at 6.5 years using questionnaires and skin prick tests (International Study of Asthma and Allergy in Childhood).
- Logistic regression models used to analyze associations between growth rates and atopic outcomes.
Main Results:
- Weight gain from birth to 3 months positively correlated with wheezing and allergic rhinitis.
- No consistent associations found between overall infant weight/length gain rates and atopic outcomes at 6.5 years.
- Current height and weight at 6.5 years were strongly associated with most atopic outcomes, independent of prior growth.
Conclusions:
- Current anthropometric measurements (height, weight) are more predictive of childhood atopy than infant growth patterns.
- The observed associations may be influenced by reverse causality or unmeasured common factors affecting both growth and atopy.
- Further research is needed to elucidate the complex interplay between growth and allergic diseases.
Background:
It has been hypothesised that postnatal weight and length/height gain are variously related to wheeze, asthma and atopy; however, supporting evidence is limited and inconsistent.
Methods:
Weights and lengths/heights of 12,171 term infants were measured from birth to 12 months and at 6.5 yr and extracted from polyclinic records prospectively obtained between 12 and 60 months. Atopic phenotypes were ascertained at 6.5 yr with the International Study of Asthma and Allergy in Childhood questionnaire and skin prick tests. Logistic regression models investigated whether rates of weight and length/height gain from infancy to mid-childhood were associated with atopy phenotypes that have occurred ever or in the last 12 months.
Results:
After controlling for confounders and prior weight and length/height gain, all weight gain variables except birth weight were positively associated with ever having wheezed (p < 0.1). A one s.d. increase in weight gain rate between 0 and 3 months was associated with a 12% increase (2-23%) in allergic rhinitis ever. No other consistent patterns of association were found for weight gain or length/height gain rate between 0 and 60 months with atopic outcomes at 6.5 yr. In contrast, all atopy outcomes except for ever having asthma were associated with current weight and height, even after controlling for prior growth.
Conclusion:
Current height and weight are more strongly associated with the development of atopic phenotypes in childhood than patterns of infant and early childhood growth, which may well reflect reverse causality (atopy effects on growth) or residual confounding by an unknown common cause of growth and atopy.
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