Wheezing and eczema in relation to infant anthropometry: evidence of developmental programming of disease in childhood.

Early life factors and, in particular, the fetal environment have been suggested to programme risk of allergic disease in later life. Diversion of nutrients away from immune organs towards the brain, a process termed brain sparing, has been proposed as a mechanism underpinning this association. The study population was a group of 256 seven-year old children from the UK recruited from two general practitioner surgeries. Historical anthropometric data from birth to age three and current anthropometry were assessed as predictors of parent-reported wheeze and eczema. Eczema at seven years was not related to any anthropometric indices at birth or during infancy. A smaller head circumference at 10-15 days of age was noted in children with current wheeze at age 7 years (P = 0.018) and this relationship persisted after adjustment for current anthropometry and confounders. Comparison of children with head circumference over 36.5 cm at 10-15 days with those with head circumference under 35.5 cm, showed reduced odds for wheeze at 7 years (OR 0.12, 95% CI 0.03-0.44, P(trend) = 0.009). These data suggest that factors that determine fetal growth may be associated with wheeze in childhood and support the developmental origins of health and disease hypothesis. Brain sparing does not appear to play a role in this early life programming.