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Fetal growth associated with childhood asthma
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Birth weight, gestational age, and fetal growth may be associated with the development of childhood asthma, recent data suggest.
“Our results indicated that risk for asthma hospitalization increased with lower birth weight and shorter gestational age,” Xiaoqin Liu, PhD, of the section for epidemiology, department of public health at Aarhus University, and colleagues wrote. “Even early term (37-38 weeks) children had a higher risk of hospitalization for asthma than full term (39-41 weeks) children.”
Investigators used national registers in Denmark, Sweden and Finland; and included all live singleton born children in Denmark during 1979-2005 (n=1,538,093), Sweden during 1973-2004 (n=3,067,670), and a 90% random sample of singleton children born in Finland during 1987-2004 (n=1,050,744). They examined 131,783 children hospitalized for asthma during follow-up.
The risk for asthma hospitalization appeared to increase consistently with lower birth weight and shorter gestational age, researchers said. They also observed that a 1,000-g decrease in birth weight correlated to a risk ratio of 1.17 (95% CI, 1.15-1.18).
Researchers said a 1-week decrease in gestational age was associated with an RR of 1.05 (95% CI, 1.04-1.06).
Full term, but not preterm-born children who were small for gestational age were more likely to have an increased risk for asthma hospitalizations, researchers said, although “the underlying mechanism is not clear. Further studies … are warranted.”
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Alexandra A. Horwitz , MD
I think the article is intriguing, as we now know that the fetal environment is critical in shaping many aspects of future health. And knowing the various risk factors for allergic and immunologic diseases in general is the stepping stone to develop preventive and novel treatments, more specifically targeting those risk factors. Allergy/Immunology doctors care for these patients, and many conduct research on the immunology of asthma. Therefore, the study would be pertinent for researchers mostly, in provoking questions and areas ripe for investigation.
The study is quite strong in size and methodology, and while for some of the specific groups, the increased risk of asthma hospitalization is small, at least on an individual level, the population-wide impact is significant. Although the results of this study may not be applicable to the general population, and will not change clinical management right now, it gives a direction for future/further research.
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