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Published on: August 7, 2017
Birth weight and asthma incidence by asthma phenotype pattern in a racially diverse cohort followed through
Christine Cole Johnson1, Edward L Peterson1, Christine L M Joseph1
1a Department of Public Health Sciences , Henry Ford Health System , Detroit , MI , USA .
Insights
Low birth weight (LBW) is linked to persistent asthma, particularly late-onset types in males and white children. LBW is not associated with asthma that resolves by adolescence.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Environmental Health
Background:
- Low birth weight (LBW) is an established risk factor for asthma.
- The specific impact of LBW on asthma onset and persistence requires further investigation.
Purpose of the Study:
- To investigate the association between LBW and asthma development.
- To determine if LBW has a greater impact on early-onset asthma.
- To analyze the relationship between LBW and asthma persistence through adolescence.
Main Methods:
- Retrospective cohort study of diverse children born 1983-1985, oversampling for LBW infants.
- Follow-up to age 17 years with face-to-face interviews using the standardized ISAAC questionnaire.
- Assessment of cumulative asthma incidence, defined by age of diagnosis and persistence/remittance.
Main Results:
- LBW was significantly associated with physician-diagnosed current asthma (p=0.003).
- The strongest association was with Late Onset Persistent asthma (diagnosed after 8 years, p=0.032), especially in males and white children.
- No statistically significant association was found between LBW and remittent asthma categories.
Conclusions:
- LBW is not linked to asthma that remits before age 17.
- LBW is associated with asthma diagnosed in mid-childhood that persists into adolescence.
- Asthmagenic effects of LBW may manifest later in childhood and continue into adulthood.
Objective:
Low birth weight (LBW) has been shown to be an independent risk factor for asthma. We hypothesized that LBW would have its greatest impact on early onset disease.
Methods:
A racially diverse cohort of children born from 1983 to 1985 at two hospitals, one urban and one suburban in the same metropolitan area, and oversampled for babies weighing ≤2500 g, was identified retrospectively when the children were 6 years of age and followed periodically. At the age 17 years study visit, cohort members and their parent/guardians were separately interviewed face-to-face regarding the subject's history of asthma using the standardized ISAAC questionnaire. We measured the cumulative incidence of asthma from birth through adolescence defined by age of diagnosis and persistence/remittance.
Results:
Six-hundred and eighty teens (82.6% of the original cohort) were included in the analyses, 387 with LBW and 293 of normal birth weight. The prevalence of physician-diagnosed "Current Asthma" was associated with LBW (p = 0.003 for trend), with patterns stronger in males and whites. LBW was associated most strongly with Late Onset Persistent asthma (current asthma that was diagnosed after 8 years); p for trend 0.032. This trend was again most evident in males and whites. None of the asthma categories classified as "remittent" were statistically associated with LBW.
Conclusions:
LBW was not associated with diagnosed asthma that remitted before age 17 years. LBW was associated with asthma diagnosis in mid-childhood that persisted through adolescence, suggesting that the asthmagenic effects of LBW can become evident post the early years of childhood and persist into adulthood.
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