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Relationship between birth weight, maternal smoking during pregnancy and childhood and adolescent lung function: A
Pallavi Balte1, Wilfried Karmaus2, Graham Roberts3
1Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
Insights
Higher birth weight and gestational age improve lung function in children. Maternal smoking during pregnancy is linked to reduced lung function, impacting children
Area of Science:
- Pediatric Pulmonology
- Developmental Pediatrics
- Epidemiology
Background:
- Low birth weight and maternal smoking during pregnancy are associated with reduced childhood lung function.
- Previous studies used cross-sectional data; longitudinal assessment is needed.
- This study investigates the long-term impact of birth weight, gestational age, and maternal smoking on lung function.
Purpose of the Study:
- To assess the effects of birth weight, gestational age, and maternal smoking during pregnancy on lung function in children at ages 10 and 18.
- To utilize repeated measurements for a more robust analysis of these associations.
- To explore the pathways linking these factors to lung function development.
Main Methods:
- Longitudinal study using the Isle of Wight birth cohort.
- Spirometry performed at ages 10 and 18 years.
- Linear mixed models and path analysis employed to analyze data, controlling for confounders.
Main Results:
- Increased birth weight correlated with higher Forced Expiratory Volume in one second (FEV1) and Forced Expiratory Flow (FEF25-75).
- Higher gestational age was positively associated with FEV1, Forced Vital Capacity (FVC), and FEF25-75 at both ages.
- Maternal smoking during pregnancy showed an inverse association with FEV1/FVC ratio and FEF25-75 at age 18.
Conclusions:
- Higher birth weight and gestational age are linked to better lung function (FEV1, FVC, FEF25-75) in children.
- Maternal smoking during pregnancy is associated with poorer lung function outcomes (reduced FEV1/FVC ratio, FEF25-75).
- Path analysis enhances understanding of prenatal and childhood factors influencing lung function development.
Background:
Low birth weight and gestational maternal smoking have been linked with reduced lung function in children in many cross sectional studies. However, these associations have not yet been assessed with repeated measurements of lung function. Our aim was to investigate the effects of birth weight, gestational age, and gestational maternal smoking on lung function in children at age 10 and 18 years.
Methods:
In the Isle of Wight birth cohort spirometry was performed at age 10 and 18 years. Information on birth weight and gestational age were obtained from hospital records. Mothers were asked about smoking during pregnancy. We employed linear mixed models to estimate the effect of these risk factors on repeated measurements of lung function. We considered maternal asthma, sex, neonatal intensive care unit admission, height, socio-economic status, personal smoking in participants at age 18, body mass index and environmental tobacco smoke exposure as potential confounders. Finally, we used path analysis to determine links between birth weight, gestational age and gestational maternal smoking on lung function at age 10 and 18 years.
Results:
Linear mixed models showed that with every 1 kg increase in birth weight, Forced expiratory volume in one second (FEV1) increased by 42.6 ± 17.2 mL and Forced expiratory flow between 25% and 75% (FEF25-75) of Forced vital capacity (FVC) increased by 95.5 ± 41.2 mL at age 18 years after adjusting for potential confounders. Path analysis suggested that birth weight had positive direct effects on FEV1 and FEF25-75 and positive indirect effect on FVC at 10 years which were carried forward to 18 years. Additionally, results also suggested a positive association between gestational age and FEV1, FVC and FEF25-75 at ages 10 and 18 years and an inverse association between gestational smoke exposure and FEV1/FVC ratio and FEF25-75 at age 18 years.
Conclusions:
Higher birth weight and gestational age were associated with higher FEV1, FVC and FEF25-75 and maternal smoking during pregnancy was associated with reduced FEV1/FVC ratio and FEF25-75. The use of path analysis can improve our understanding of underlying "causal" pathways among different prenatal and childhood factors that affect lung function in both pre-adolescent and adolescent periods.
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