Abstract
Information on the association between maternal prepregnancy body weight, gestational weight change, and childhood allergies is not consistent. Little is known on whether there is a combined association with comprehensive childhood allergies. To examine the association of maternal prepregnancy body mass index and gestational weight gain (GWG) with the risk of childhood allergic diseases including asthma and/or wheezing, allergic rhinitis, eczema, and food and/or drug allergy. This cross-sectional study was conducted from April 12 to June 1, 2019, using the Shanghai Children Allergy Study (SCAS), a large, population-based survey. A multistage and multistrata sampling approach was applied to conduct the survey in 13 districts across Shanghai, China, with an enrollment of 15 145 mother-child pairs. Reported maternal weight before pregnancy and at the time of delivery were requested in the survey; GWG was examined in absolute terms and with reference to the Institute of Medicine guideline. The ascertainment of allergic diseases was based on the International Study of Asthma and Allergies in Childhood questionnaire. Among 15 145 children aged 3 to 14 years (7911 [52.2%] boys) within the SCAS, 8877 children (58.6%) were screened for allergic diseases. Multivariable log-binomial regression models suggested that excessive GWG was associated with risks of 19% for asthma/wheezing, 11% for allergic rhinitis, and 10% for eczema in the children. Gestational weight gain extremely above the Institute of Medicine guideline in women who were overweight/obese before pregnancy was associated with the highest risk of childhood asthma/wheezing (adjusted prevalence ratio, 1.42; 95% CI, 1.16-1.74; P = .001), allergic rhinitis (adjusted prevalence ratio, 1.32; 95% CI, 1.12-1.56; P = .001), and eczema (adjusted prevalence ratio, 1.24; 95% CI, 1.08-1.41; P = .002). Gestational weight gain below the Institute of Medicine guideline was associated with an attenuated risk of 13% for childhood asthma/wheezing, 11% for allergic rhinitis, 14% for eczema, and 15% food/drug allergy when mothers were of prepregnancy normal weight; similar associations were observed in underweight mothers, but there was no association in overweight mothers. Generally, the associations were similar in the stratified analysis according to children's age group. Moreover, the results were similar in the allergen test subgroup. The findings of this study suggest that excessive GWG may be a risk factor for childhood allergic diseases. Further studies on the long-term effects of the intrauterine environment on children's health may take maternal weight management during pregnancy into consideration since GWG could be a controllable and modifiable risk factor.
Highlights
IntroductionChina, is a fast-growing city with rapid urbanization that had brought about great changes on lifestyle, accompanied by an increasing prevalence of obesity in the general population as well as in pregnant women.[1] In 2009, the Institute of Medicine (IOM) published a guideline recommending the appropriate gestational weight gain range for pregnant women in the US.[2] A national survey conducted from 2010 to 2011 revealed that, among US women, only 32% met the IOM standard; 47% exceeded the proper range, defined as excessive gestational weight gain (GWG).[3] A rapid increase in the prevalence of childhood allergic diseases has attracted global attention.[4] The prevalence of childhood allergic diseases increased nearly 5-fold in the period from 1990 to 2011 in China.[5] A 10-city survey illustrated that Shanghai had the highest prevalence of childhood allergic diseases except wheezing.[6] Data have suggested that, allergic diseases can begin in early childhood, they generally persist into adulthood and result in morbidity throughout life.[7]
Shanghai, China, is a fast-growing city with rapid urbanization that had brought about great changes on lifestyle, accompanied by an increasing prevalence of obesity in the general population as well as in pregnant women.[1]
Gestational weight gain extremely above the Institute of Medicine guideline in women who were overweight/obese before pregnancy was associated with the highest risk of childhood asthma/wheezing, allergic rhinitis, and eczema
Summary
China, is a fast-growing city with rapid urbanization that had brought about great changes on lifestyle, accompanied by an increasing prevalence of obesity in the general population as well as in pregnant women.[1] In 2009, the Institute of Medicine (IOM) published a guideline recommending the appropriate gestational weight gain range for pregnant women in the US.[2] A national survey conducted from 2010 to 2011 revealed that, among US women, only 32% met the IOM standard; 47% exceeded the proper range, defined as excessive gestational weight gain (GWG).[3] A rapid increase in the prevalence of childhood allergic diseases has attracted global attention.[4] The prevalence of childhood allergic diseases increased nearly 5-fold in the period from 1990 to 2011 in China.[5] A 10-city survey illustrated that Shanghai had the highest prevalence of childhood allergic diseases except wheezing.[6] Data have suggested that, allergic diseases can begin in early childhood, they generally persist into adulthood and result in morbidity throughout life.[7]
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