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Published on: August 7, 2017
Preterm infant growth and asthma at age 8 years
Mandy B Belfort1, Robyn T Cohen2, Lawrence M Rhein3
1Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Insights
Rapid body mass index (BMI) gain in the first year of life is linked to increased asthma risk in preterm infants. Linear growth did not show a protective effect against childhood asthma.
Area of Science:
- Pediatric Health
- Neonatal Development
- Respiratory Medicine
Background:
- Preterm infants are at higher risk for adverse health outcomes, including asthma.
- Early childhood growth patterns, particularly body mass index (BMI) and linear growth, are critical for long-term health.
- Understanding the relationship between infant growth and later asthma development is crucial for early intervention.
Purpose of the Study:
- To investigate the association between body mass index (BMI) gain and linear growth from infancy to 18 months with the incidence of asthma at 8 years of age.
- To determine if rapid BMI gain increases asthma risk and if rapid linear growth offers protection in preterm infants.
- To explore growth trajectories in the first year of life and their impact on respiratory health in later childhood.
Main Methods:
- Secondary analysis of the Infant Health and Development Program cohort.
- Inclusion of 863 preterm infants (birth weight ≤2500g, gestational age ≤37 weeks).
- Assessment of BMI and linear growth z-scores from term to 18 months, and asthma diagnosis at 8 years via parent report.
Main Results:
- Asthma was diagnosed in 17% of children by age 8.
- Each z-score increase in BMI gain from term to 4 months was associated with a 30% higher odds of asthma (OR 1.3, 95% CI 1.1-1.5).
- Similar associations were observed for BMI gain between 4-12 months; linear growth showed no significant association with asthma risk.
Conclusions:
- Accelerated BMI gain during the first year of life is associated with an increased likelihood of developing asthma in preterm infants.
- Linear growth in infancy did not demonstrate a protective effect against childhood asthma.
- These findings suggest that excessive weight gain in early life may negatively impact respiratory health in preterm infants, underscoring the importance of monitoring growth patterns.
Objectives:
To examine associations of gain in body mass index (BMI) and linear growth from term to 18 months with asthma at age 8 years in a cohort of preterm infants. We hypothesised that rapid BMI gain would increase asthma risk, whereas rapid linear growth would be protective.
Design:
Observational secondary analysis of data from the Infant Health and Development Program.
Setting:
8 centres in the USA.
Patients:
863 preterm (≤37 weeks), low birthweight (≤2500 g) children.
Main Exposure Variables:
Gain in BMI and linear growth from term to 4 months, 4-12 months and 12-18 months, in z-scores.
Main Outcome Measure:
Asthma at age 8 years, assessed by parent report of the child ever receiving the diagnosis from a doctor.
Results:
At age 8 years, 149 (17%) had ever been diagnosed with asthma. Adjusting for maternal and child factors in logistic regression, for each additional z-score gain in BMI from term to 4 months, odds of asthma at age 8 years were higher (OR 1.3, 95% CI 1.1 to 1.5); findings were similar for BMI gain from 4-12 months. More rapid linear growth from term to 4 months was not associated with lower odds of asthma (OR 1.1, 95% CI 0.9 to 1.3), with similar findings for 4-12 months and 12-18 months.
Conclusions:
More rapid BMI gain in the 1st year of life was associated with higher odds of asthma, whereas linear growth did not appear protective. Our results add to mounting evidence that excess weight gain after term may be harmful to preterm infants.
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