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Non-linear association of birth weight with lung function and risk of asthma: A population-based study
Meng Yang1, Hong Mei1, Juan Du1
1Institute of Maternal and Child Health, Wuhan Maternal and Child Health Care Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Birth weight impacts childhood lung function non-linearly. Lower birth weights (<3.6 kg) positively correlate with lung function, while higher weights (≥3.6 kg) show negative associations, suggesting a complex relationship with asthma risk.
Area of Science:
- Pediatric Pulmonology
- Environmental Health
- Epidemiology
Background:
- The relationship between birth weight and children's lung function and asthma risk is not fully understood.
- Investigating this association is crucial for understanding early life determinants of respiratory health.
Purpose of the Study:
- To examine the specific association between birth weight and lung function metrics.
- To determine the link between birth weight and the risk of asthma in children.
Main Methods:
- Cross-sectional analysis of 3,295 children (aged 6-15 years) from the NHANES (2007-2012).
- Generalized linear and additive models were used to assess linear and non-linear associations, controlling for covariates.
Main Results:
- A non-linear association was observed between birth weight and FEV1%predicted, FEV1/FVC%predicted, and FEF25-75%predicted (P<0.01).
- A threshold of 3.6 kg for birth weight was identified; weights below this were positively associated with lung function, while weights above showed negative associations.
- A potential non-linear relationship between birth weight and asthma risk was also detected.
Conclusions:
- Birth weight exhibits a complex, non-linear association with lung function in children.
- The findings suggest a critical birth weight threshold (3.6 kg) influencing respiratory health outcomes.
- Further research is needed to confirm these findings and elucidate clinical significance.
Background:
The impact of birth weight on lung function and risk of asthma remains contentious. Our aim was to investigate the specific association of birth weight with lung function and the risk of asthma in children.
Methods:
We performed cross-sectional analyses of 3,295 children aged 6-15 years who participated in the 2007-2012 National Health and Nutrition Examination Survey (NHANES). After controlling for potential covariates other than gestational diabetes, maternal asthma and obesity, the linear and non-linear associations of birth weight with lung function metrics and the risk of asthma were evaluated by a generalized linear model and generalized additive model, respectively.
Results:
We observed a non-linear association of birth weight with FEV1 %predicted, FEV1/FVC %predicted and FEF25 - 75 %predicted (P for non-linearity was 0.0069, 0.0057, and 0.0027, respectively). Further threshold effect analysis of birth weight on lung function detected the turning point for birth weight was 3.6 kg. When the birth weight was < 3.6 kg, birth weight was significantly positively associated with all pulmonary function metrics. However, negative associations were found in FEV1 %predicted, FEV1/FVC %predicted and FEF25 - 75 %predicted when the birth weight was ≥3.6 kg. These results were consistent in the stratified and sensitivity analyses. Additionally, a possible non-linear relationship was also detected between birth weight and the risk of asthma.
Conclusion:
Although not all maternal factors were accounted for, our findings provided new insight into the association of birth weight with lung function. Future studies are warranted to confirm the present findings and understand the clinical significance.
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