Herman T den Dekker1, Agnes M M Sonnenschein-van der Voort1, Johan C de Jongste2, Isabella Anessi-Maesano3, S Hasan Arshad4, Henrique Barros5, Caroline S Beardsmore6, Hans Bisgaard7, Sofia Correia Phar5, Leone Craig8, Graham Devereux9, C Kors van der Ent10, Ana Esplugues11, Maria P Fantini12, Claudia Flexeder13, Urs Frey14, Francesco Forastiere15, Ulrike Gehring16, Davide Gori12, Anne C van der Gugten10, A John Henderson17, Barbara Heude18, Jesús Ibarluzea19, Hazel M Inskip20, Thomas Keil21, Manolis Kogevinas22, Eskil Kreiner-Møller7, Claudia E Kuehni23, Susanne Lau24, Erik Mélen25, Monique Mommers26, Eva Morales27, John Penders26, Katy C Pike28, Daniela Porta15, Irwin K Reiss29, Graham Roberts4, Anne Schmidt30, Erica S Schultz25, Holger Schulz13, Jordi Sunyer27, Matias Torrent31, Maria Vassilaki32, Alet H Wijga33, Carlos Zabaleta34, Vincent W V Jaddoe35, Liesbeth Duijts36. 1. Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands. 2. Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands. 3. EPAR, UMR-S 707 INSERM Paris, France; EPAR, UMR-S 707, Université Pierre et Marie Curie Paris, France. 4. David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight, United Kingdom; Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom. 5. Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. 6. Division of Child Health, Department of Infection, Immunity & Inflammation, University of Leicester and Institute for Lung Health, Leicester, United Kingdom. 7. Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2000), Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; Danish Pediatric Asthma Center, Copenhagen University Hospital, Gentofte, Denmark. 8. Public Health Nutrition Research Group, University of Aberdeen, Aberdeen, United Kingdom; Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom. 9. Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom. 10. Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. 11. Faculty of Nursing and Chiropody, Valencia, Spain; FISABIO, Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 12. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. 13. Helmholtz Zentrum München, Institute of Epidemiology I, Neuherberg, Germany. 14. University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland. 15. Department of Epidemiology, Lazio Regional Health Service, Rome, Italy. 16. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands. 17. School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom. 18. CESP Inserm, UMRS 1018, Team 10, Villejuif, France; Université Paris-Sud, UMRS 1018 Team 10, Villejuif, France. 19. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Public Health Division of Gipuzkoa, San Sebastian, Spain. 20. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom. 21. Institute of Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, Berlin, Germany; Institute for Clinical Epidemiology and Biometry, University of Würzburg, Wurzburg, Germany. 22. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National School of Public Health, Athens, Greece; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain. 23. Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. 24. Department of Pediatric Pneumology and Immunology, Charité University Medical Centre, Berlin, Germany. 25. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, and Sach's Children Hospital, Stockholm, Switzerland. 26. Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. 27. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain. 28. Faculty of Medicine, University of Southampton, Southampton, United Kingdom. 29. Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands. 30. University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland; Division of Respiratory Medicine, Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland. 31. IB-SALUT, Area de Salut de Menorca, Balearic Islands, Spain. 32. Department of Social Medicine, School of Medicine, University of Crete, Crete, Greece. 33. Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands. 34. Nuestra Señora de la Antigua Hospital, OSAKIDETZA Basque Health Service, San Sebastian, Spain. 35. Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands. 36. Department of Pediatrics, Division of Respiratory Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus University Medical Center, Rotterdam, The Netherlands. Electronic address: l.duijts@erasmusmc.nl.
Abstract
BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. RESULTS: Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P < .05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P < .05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. CONCLUSIONS: Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.
BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children from 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth characteristics with childhood asthma. RESULTS: Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1 but higher FEV1/FVC ratio (P < .05). Greater infant weight gain was associated with higher FEV1 but lower FEV1/FVC ratio and FEF75 in childhood (P < .05). All associations were present across the full range and independent of other early-life growth characteristics. Preterm birth, low birth weight, and greater infant weight gain were associated with an increased risk of childhood asthma (pooled odds ratio, 1.34 [95% CI, 1.15-1.57], 1.32 [95% CI, 1.07-1.62], and 1.27 [95% CI, 1.21-1.34], respectively). Mediation analyses suggested that FEV1, FEV1/FVC ratio, and FEF75 might explain 7% (95% CI, 2% to 10%) to 45% (95% CI, 15% to 81%) of the associations between early growth characteristics and asthma. CONCLUSIONS: Younger gestational age, smaller size for gestational age, and greater infant weight gain were across the full ranges associated with childhood lung function. These associations explain the risk of childhood asthma to a substantial extent.
Authors: Nikos Stratakis; Theano Roumeliotaki; Emily Oken; Ferran Ballester; Henrique Barros; Mikel Basterrechea; Sylvaine Cordier; Renate de Groot; Herman T den Dekker; Liesbeth Duijts; Merete Eggesbø; Maria Pia Fantini; Francesco Forastiere; Ulrike Gehring; Marij Gielen; Davide Gori; Eva Govarts; Hazel M Inskip; Nina Iszatt; Maria Jansen; Cecily Kelleher; John Mehegan; Carolina Moltó-Puigmartí; Monique Mommers; Andreia Oliveira; Sjurdur F Olsen; Fabienne Pelé; Costanza Pizzi; Daniela Porta; Lorenzo Richiardi; Sheryl L Rifas-Shiman; Sian M Robinson; Greet Schoeters; Marin Strøm; Jordi Sunyer; Carel Thijs; Martine Vrijheid; Tanja G M Vrijkotte; Alet H Wijga; Manolis Kogevinas; Maurice P Zeegers; Leda Chatzi Journal: Int J Epidemiol Date: 2017-10-01 Impact factor: 7.196
Authors: Alison G Lee; Yueh-Hsiu M Chiu; Maria J Rosa; Sheldon Cohen; Brent A Coull; Robert O Wright; Wayne J Morgan; Rosalind J Wright Journal: Ann Allergy Asthma Immunol Date: 2017-06-28 Impact factor: 6.347
Authors: S Hasan Arshad; John W Holloway; Wilfried Karmaus; Hongmei Zhang; Susan Ewart; Linda Mansfield; Sharon Matthews; Claire Hodgekiss; Graham Roberts; Ramesh Kurukulaaratchy Journal: Int J Epidemiol Date: 2018-08-01 Impact factor: 7.196
Authors: Carsten Flohr; A John Henderson; Michael S Kramer; Rita Patel; Jennifer Thompson; Sheryl L Rifas-Shiman; Seungmi Yang; Konstantin Vilchuck; Natalia Bogdanovich; Mikhail Hameza; Richard M Martin; Emily Oken Journal: JAMA Pediatr Date: 2018-01-02 Impact factor: 16.193
Authors: Erick Forno; Daniel J Weiner; James Mullen; Gregory Sawicki; Geoffrey Kurland; Yueh Ying Han; Michelle M Cloutier; Glorisa Canino; Scott T Weiss; Augusto A Litonjua; Juan C Celedón Journal: Am J Respir Crit Care Med Date: 2017-02-01 Impact factor: 21.405
Authors: Amy L Wooldridge; Robert J Bischof; Hong Liu; Gary K Heinemann; Damien S Hunter; Lynne C Giles; Rebecca A Simmons; Yu-Chin Lien; Wenyun Lu; Joshua D Rabinowitz; Karen L Kind; Julie A Owens; Vicki L Clifton; Kathryn L Gatford Journal: Am J Physiol Regul Integr Comp Physiol Date: 2017-10-04 Impact factor: 3.619