Abstract

A number of studies have linked obesity with asthma in adults and children. Few longitudinal studies have evaluated the effect of maternal pre-pregnancy obesity on either asthma or early childhood respiratory morbidity, and these have not been in urban, nonwhite populations. We sought to determine whether pre-pregnancy obesity was associated with recurrent wheezing in an urban, nonwhite population. This study includes 1,191 children from the Boston Birth Cohort (1998–present) followed prospectively to a mean age of 3.0 ± 2.4 years with study visits aligned with the pediatric primary care schedule. Multivariate logistic regression was used to evaluate the associations of maternal pre-pregnancy obesity (body mass index ≥30) with recurrent wheezing (≥4 lifetime episodes). Secondary outcomes included log-transformed cord-blood immunoglobulin E (Phadia), and physician diagnoses of eczema and food allergy. Pre-pregnancy obesity was present in 20.7% of mothers. Of the 1,191 children, 60 (5%) developed recurrent wheezing. Children of obese mothers had an increased risk of recurrent wheezing (adjusted odds ratio, 95% confidence interval: 3.51, 1.68–7.32). These associations persisted even after adjustment for fetal growth status. In contrast, maternal obesity was not associated with eczema or food allergy, and was inversely associated with log cord-blood immunoglobulin E (β, 95% confidence interval: −0.34, −0.66 to −0.02). In this predominantly urban, multiracial/ethnic birth cohort, maternal pre-pregnancy obesity was associated with an increased risk of recurrent wheezing. This association was not explained by fetal growth or increased atopy. Maternal pre-pregnancy obesity is a prevalent risk factor for respiratory morbidity in this urban, nonwhite population.

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cover image Pediatric Allergy, Immunology, and Pulmonology
Pediatric Allergy, Immunology, and Pulmonology
Volume 23Issue Number 3September 2010
Pages: 183 - 190
PubMed: 22375278

History

Published online: 1 November 2010
Published ahead of print: 9 October 2010
Published in print: September 2010
Accepted: 22 August 2010
Received: 20 July 2010

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Rajesh Kumar, M.D.
Division of Allergy and Immunology, Children's Memorial Hospital, Chicago, Illinois.
Rachel E. Story, M.D., M.P.H.
Division of Allergy and Immunology, Children's Memorial Hospital, Chicago, Illinois.
Jacqueline A. Pongracic, M.D.
Division of Allergy and Immunology, Children's Memorial Hospital, Chicago, Illinois.
Xiumei Hong, M.D., Ph.D.
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.
Lester Arguelles, Ph.D.
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.
Guoying Wang, M.D., Ph.D.
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.
Nataliya Kuptsova-Clarkson, M.D., Ph.D.
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.
Colleen Pearson, B.A.
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Kathryn Ortiz, B.A.
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Anthony Bonzagni, B.A.
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Stephanie Apollon, B.A.
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Lingling Fu, M.S.
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.
Howard Bauchner, M.D.
*
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts.
Xiaobin Wang, M.D., Sc.D.*
The Mary Ann and J. Milburn Smith Child Health Research Program, Children's Memorial Research Center, Children's Memorial Hospital, Chicago, Illinois.

Notes

Address correspondence to:Rajesh Kumar, M.D.Division of Allergy and ImmunologyChildren's Memorial Hospital2300 Children's Plaza, Box #60Chicago, IL 60614E-mail: [email protected]

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None of the authors have conflicts of interest to disclose.

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