Contribution of Gestational Weight Gain to Childhood Asthma Phenotypes: A Prospective Cohort Study

Abstract

BackgroundThe contribution of prenatal anthropometric measures to the development of specific childhood asthma phenotypes is not known. ObjectiveWe aimed to evaluate associations between prepregnancy body mass index (BMI) and gestational weight gain (GWG) with allergic and non-allergic asthma phenotypes in childhood. MethodsOur study population included term, healthy infants in the middle Tennessee region of the United States. Prepregnancy BMI and GWG were ascertained from questionnaires administered during early infancy and categorized based on World Health Organization (WHO) and Institute of Medicine (IOM) recommendations, respectively. Allergic asthma was defined as 5-year current asthma and a positive skin test or specific IgE to aeroallergen(s). We used multivariable logistic regression models for asthma and multinomial logistic regression models for non-asthma, allergic asthma, and non-allergic asthma. ResultsA total of 1,266 children were included. At the 5-year follow-up, 194 (15.3%) had asthma; among them, 102 (52.6%) had allergic asthma. Both inadequate and excessive GWG, compared to adequate GWG, were associated with increased odds of asthma (inadequate: aOR 1.76 [95% CI: 1.03–2.98]; excessive: aOR 1.70 [95% CI: 1.12–2.57]) and increased odds of allergic asthma compared to no asthma (inadequate: aOR 3.49 [95% CI: 1.66–7.32]; excessive: aOR 2.55 [95% CI: 1.34–4.85]). Prepregnancy BMI was not associated with asthma nor with asthma phenotypes. ConclusionBoth inadequate and excessive GWG were associated with allergic asthma risk. These results support the benefits of optimal GWG during pregnancy on child health outcomes.