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Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma.
Pediatrics. 2014 Aug; 134(2):e535-46.Ped

Abstract

BACKGROUND AND OBJECTIVE

Environmental or lifestyle exposures in utero may influence the development of childhood asthma. In this meta-analysis, we aimed to assess whether maternal obesity in pregnancy (MOP) or increased maternal gestational weight gain (GWG) increased the risk of asthma in offspring.

METHODS

We included all observational studies published until October 2013 in PubMed, Embase, CINAHL, Scopus, The Cochrane Database, and Ovid. Random effects models with inverse variance weights were used to calculate pooled risk estimates.

RESULTS

Fourteen studies were included (N = 108 321 mother-child pairs). Twelve studies reported maternal obesity, and 5 reported GWG. Age of children was 14 months to 16 years. MOP was associated with higher odds of asthma or wheeze ever (OR = 1.31; 95% confidence interval [CI], 1.16-1.49) or current (OR = 1.21; 95% CI, 1.07-1.37); each 1-kg/m(2) increase in maternal BMI was associated with a 2% to 3% increase in the odds of childhood asthma. High GWG was associated with higher odds of asthma or wheeze ever (OR = 1.16; 95% CI, 1.001-1.34). Maternal underweight and low GWG were not associated with childhood asthma or wheeze. Meta-regression showed a negative association of borderline significance for maternal asthma history (P = .07). The significant heterogeneity among existing studies indicates a need for standardized approaches to future studies on the topic.

CONCLUSIONS

MOP and high GWG are associated with an elevated risk of childhood asthma; this finding may be particularly significant for mothers without asthma history. Prospective randomized trials of maternal weight management are needed.

Authors+Show Affiliations

Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;University of Pittsburgh Medical School, Pittsburgh, Pennsylvania; erick.forno@chp.edu.University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania; and.Division of Allergy and Immunology, Lurie Children's Hospital, Chicago, Illinois.University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania; and.Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

25049351

Citation

Forno, Erick, et al. "Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma." Pediatrics, vol. 134, no. 2, 2014, pp. e535-46.
Forno E, Young OM, Kumar R, et al. Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. Pediatrics. 2014;134(2):e535-46.
Forno, E., Young, O. M., Kumar, R., Simhan, H., & Celedón, J. C. (2014). Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. Pediatrics, 134(2), e535-46. https://doi.org/10.1542/peds.2014-0439
Forno E, et al. Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma. Pediatrics. 2014;134(2):e535-46. PubMed PMID: 25049351.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma. AU - Forno,Erick, AU - Young,Omar M, AU - Kumar,Rajesh, AU - Simhan,Hyagriv, AU - Celedón,Juan C, Y1 - 2014/07/21/ PY - 2014/7/23/entrez PY - 2014/7/23/pubmed PY - 2014/9/30/medline KW - asthma risk factors KW - childhood asthma KW - gestational weight gain KW - maternal obesity KW - meta-analysis SP - e535 EP - 46 JF - Pediatrics JO - Pediatrics VL - 134 IS - 2 N2 - BACKGROUND AND OBJECTIVE: Environmental or lifestyle exposures in utero may influence the development of childhood asthma. In this meta-analysis, we aimed to assess whether maternal obesity in pregnancy (MOP) or increased maternal gestational weight gain (GWG) increased the risk of asthma in offspring. METHODS: We included all observational studies published until October 2013 in PubMed, Embase, CINAHL, Scopus, The Cochrane Database, and Ovid. Random effects models with inverse variance weights were used to calculate pooled risk estimates. RESULTS: Fourteen studies were included (N = 108 321 mother-child pairs). Twelve studies reported maternal obesity, and 5 reported GWG. Age of children was 14 months to 16 years. MOP was associated with higher odds of asthma or wheeze ever (OR = 1.31; 95% confidence interval [CI], 1.16-1.49) or current (OR = 1.21; 95% CI, 1.07-1.37); each 1-kg/m(2) increase in maternal BMI was associated with a 2% to 3% increase in the odds of childhood asthma. High GWG was associated with higher odds of asthma or wheeze ever (OR = 1.16; 95% CI, 1.001-1.34). Maternal underweight and low GWG were not associated with childhood asthma or wheeze. Meta-regression showed a negative association of borderline significance for maternal asthma history (P = .07). The significant heterogeneity among existing studies indicates a need for standardized approaches to future studies on the topic. CONCLUSIONS: MOP and high GWG are associated with an elevated risk of childhood asthma; this finding may be particularly significant for mothers without asthma history. Prospective randomized trials of maternal weight management are needed. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/25049351/Maternal_obesity_in_pregnancy_gestational_weight_gain_and_risk_of_childhood_asthma_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=25049351 DB - PRIME DP - Unbound Medicine ER -