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Contribution of Gestational Weight Gain to Childhood Asthma Phenotypes: A Prospective Cohort Study
Akihiro Shiroshita1, Tebeb Gebretsadik2, Larry J Anderson3
1Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
Insights
Gestational weight gain (GWG) outside the recommended range is linked to childhood allergic asthma. Optimal GWG during pregnancy may benefit child health outcomes, while prepregnancy BMI showed no association.
Area of Science:
- Pediatric Allergy and Immunology
- Maternal-Fetal Medicine
- Public Health
Background:
- The relationship between prenatal anthropometric measurements and specific childhood asthma phenotypes remains unclear.
- Understanding these links is crucial for developing targeted preventive strategies.
Purpose of the Study:
- To investigate the association between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and nonallergic asthma phenotypes in children.
- To determine if deviations from recommended GWG impact asthma development.
Main Methods:
- A cohort of 1266 healthy infants was studied in Tennessee.
- Prepregnancy BMI and GWG were assessed via questionnaires and categorized using established guidelines.
- Asthma phenotypes at age 5 were defined, including allergic asthma (current asthma with positive allergy tests).
- Multivariable and multinomial logistic regression models were employed for analysis.
Main Results:
- At 5 years, 15.3% of children had asthma, with 52.6% of those classified as allergic asthma.
- Both inadequate and excessive GWG were significantly associated with increased odds of asthma and allergic asthma.
- Prepregnancy BMI did not show a significant association with asthma or its phenotypes.
Conclusions:
- Inadequate and excessive gestational weight gain are risk factors for developing allergic asthma in children.
- Maintaining optimal gestational weight gain is recommended to promote positive child health outcomes.
- Further research into prenatal factors influencing childhood asthma is warranted.
Background:
The contribution of prenatal anthropometric measures to the development of specific childhood asthma phenotypes is not known.
Objective:
We aimed to evaluate associations between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and nonallergic asthma phenotypes in childhood.
Methods:
Our study population included term, healthy infants in the middle Tennessee region of the United States. Prepregnancy BMI and GWG were ascertained from questionnaires administered during early infancy and categorized based on World Health Organization and Institute of Medicine recommendations, respectively. Allergic asthma was defined as 5-year current asthma and a positive skin test or specific IgE to aeroallergen(s). We used multivariable logistic regression models for asthma and multinomial logistic regression models for nonasthma, allergic asthma, and nonallergic asthma.
Results:
A total of 1266 children were included. At the 5-year follow-up, 194 (15.3%) had asthma; among them, 102 (52.6%) had allergic asthma. Both inadequate and excessive GWG, compared with adequate GWG, were associated with increased odds of asthma (inadequate: adjusted odds ratio [aOR]: 1.76 [95% confidence interval (CI): 1.03-2.98]; excessive: aOR: 1.70 [95% CI: 1.12-2.57]) and increased odds of allergic asthma compared with no asthma (inadequate: aOR: 3.49 [95% CI: 1.66-7.32]; excessive: aOR: 2.55 [95% CI: 1.34-4.85]). Prepregnancy BMI was not associated with asthma nor with asthma phenotypes.
Conclusions:
Both inadequate and excessive GWG were associated with allergic asthma risk. These results support the benefits of optimal GWG during pregnancy on child health outcomes.
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