Maternal Pre-Pregnancy Obesity and Recurrent Wheezing in Early Childhood

Kumar, R.; Story, R. E.; Pongracic, J. A.; Hong, X.; Arguelles, L.; Wang, G.; Kuptsova-Clarkson, N.; Pearson, C.; Ortiz, K.; Bonzagni, A.; Apollon, S.; Fu, L.; Bauchner, H.; Wang, X.

Pediatr Allergy Immunol Pulmonol. 2010 Sep 1; 23(3):183-190

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 (beta, 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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