哮喘联盟

   摘要
   背景：孕妇肥胖与子代哮喘有关，但是孕妇肥胖与其他过敏相关的疾病及其与年龄超过学龄初期的关系在很大程度上还尚未被研究。
   目标：观察孕期BMI和子代到16岁时哮喘、鼻炎、湿疹和过敏之间的关系。研究纳入3294例来自瑞典的出生队列BAMSE儿童。妊娠10周左右对孕期BMI进行评估。在儿童1、2、4、8、12、16岁时进行家长问卷，调查获得哮喘、鼻炎、湿疹、生活方式和环境暴露的信息。通过2850例儿童子样本在4岁、8岁和16岁吸入性过敏原的IgE水平定义过敏。使用广义评估方程模型分析孕妇BMI和子代1-16岁预后的相关性。孕妇BMI与到子代16岁的整体哮喘危险呈正相关（哮喘流行率调整比值比或每5公斤/平方米增加：1.23；95% CI 1.07-1.40）不包括体重过轻的母亲。相反，未发现与鼻炎、湿疹或过敏的显著相关性。与哮喘的相关性被限制为肥胖，而不是超重的母亲，但子代在调整超重和后这一相关性减弱。一个在16岁进行的因果推理测试进一步表明，孩子自身的超重是孕妇BMI和子代16岁哮喘之间相关性的调节因素。
   结论和临床意义：孕妇BMI与哮喘的风险增加有关，但与鼻炎、湿疹或过敏无关，然而子代超重似乎在其中存在调节作用。孕妇怀孕前和儿童期肥胖的预防策略对于减少儿童哮喘患病率可能是重要的。
 

（林江涛 审校）
Clin Exp Allergy. 2014 May 8. doi: 10.1111/cea.12340. [Epub ahead of print]

 

Maternal BMI in early pregnancy and offspring asthma, rhinitis and eczema up to 16 years of age.
 

Ekström S1, Magnusson J, Kull I, Lind T, Almqvist C, Melén E, Bergström A.
 

ABSTRACT
BACKGROUND: Maternal obesity has been linked to offspring asthma, however other allergy-related diseases, as well as the association beyond early school-age are largely unstudied.
OBJECTIVE: To examine the associations between maternal BMI in pregnancy and offspring asthma, rhinitis, eczema and sensitization up to 16 years of age.
METHODS: 3,294 children from the Swedish birth cohort BAMSE were included in the analyses. Maternal BMI was assessed around week 10 in pregnancy. Information on asthma, rhinitis, eczema, lifestyle factors and environmental exposures were obtained by parental questionnaires at 1, 2, 4, 8, 12 and 16 years. Sensitization was defined from IgE levels of inhalant allergens at 4, 8 and 16 years in a subsample of 2,850 children. Generalized estimated equation models were used to analyze the associations between maternal BMI and the outcomes at 1-16 years.
RESULTS: Maternal BMI was positively associated with overall risk of asthma up to age 16 years (adj OR per 5 kg/m2 increase: 1.23; 95% CI 1.07-1.40 for prevalent asthma) excluding underweight mothers. In contrast, no significant associations were found for rhinitis, eczema or sensitization. The association with asthma was restricted to obese, rather than overweight mothers, but was attenuated when adjusting for overweight in the offspring. A causal inference test at 16 years further indicated that the child's own overweight is a mediator in the suggested association between maternal BMI and offspring asthma at 16 years.
CONCLUSIONS AND CLINICAL RELEVANCE: Maternal BMI is associated with an increased risk of asthma, but not rhinitis, eczema or sensitization, however overweight in the offspring seem to have a mediating role. Prevention strategies of maternal pre-pregnancy and childhood obesity might be important to reduce the prevalence of childhood asthma.
 

Clin Exp Allergy. 2014 May 8. doi: 10.1111/cea.12340. [Epub ahead of print]