Maternal weight issues spell wheezing trouble for children

By Afsaneh Gray, medwireNews Reporter

High maternal weight and gestational weight gain are independently associated with an increased risk for wheezing in preschool age children, a Dutch study has found.

Study author Liesbeth Duijts (Erasmus Medical Center, Rotterdam) and team point out: “Given the high prevalence and considerable impact of childhood asthma on morbidity and healthcare costs, a causal pathway between maternal weight and preschool wheezing would be of great importance for public health.”

A total of 4656 mothers and their children were included in the study, which was carried out as part of a bigger project, the Generation R Study, a population-based prospective cohort study from early fetal life onwards. Maternal height and weight were measured in the first, second, and third trimesters of pregnancy, and prepregnancy weight was obtained from the mother at intake.

Gestational weight gain was defined as the difference between maternal weight before pregnancy and that measured in the third trimester (at a median of 30.2 weeks of gestational age). Information about wheezing was obtained by questionnaires when children were 1, 2, 3, and 4 years of age.

In mothers with a history of asthma or atopy, prepregnancy obesity (body mass index [BMI] ≥30 kg/m² vs <25 kg/m²) was associated with a higher risk for wheezing in their children (odds ratio [OR]=1.47). However, the effect was only significant for children between 2 and 4 years of age, and no association was observed among children whose mothers had no history of asthma or atopy.

The researchers also found that each standard deviation increase of gestational weight gain was associated with an overall increase of wheezing in preschool children aged 1 to 4 years (OR=1.09), with the strongest association seen for wheezing at 1 year. This association was independent of prepregnancy BMI and did not differ between mothers with and without a history of asthma or atopy.

“These findings suggest that these associations of maternal pre-pregnancy BMI and gestational weight gain on childhood wheezing operate through different underlying mechanisms,” write the authors in the European Respiratory Journal. However, they say that more research is needed to identify what these mechanisms may be.

Neither association was explained by factoring in the child’s own height and weight, or whether or not they had respiratory tract infections or eczema.

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