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Accelerated growth in the first three months
of life, but not fetal growth, is associated
with an increased risk of asthma symptoms in
young children, according to a new study
from The Generation R Study Group at Erasmus
Medical Center in the Netherlands.
“We know that low birth weight is associated
with an increased risk of asthma symptoms in
children, but the effects of specific fetal
and infant growth patterns on this risk had
not been examined yet,” said researcher
Liesbeth Duijts, MD, PhD. “In our study,
weight gain acceleration in early infancy
was associated with an increased risk of
asthma symptoms in children of preschool
age, independent of fetal growth patterns,
suggesting that early infancy might be a
critical period for the development of
asthma.”
The findings were published online ahead of
print publication in the American Thoracic
Society’s American Journal of Respiratory
and Critical Care Medicine.
This study was embedded in the Generation R
Study, a population-based prospective cohort
study, and included 5,125 children who were
followed from fetal life through the age of
four. Information on asthma symptoms was
obtained by questionnaires at the ages of 1,
2, 3, and 4.
No consistent relationships between fetal
length and weight growth during different
trimesters and the development of asthma
symptoms were observed. Accelerated weight
gain from birth to 3 months following normal
fetal growth was associated with increased
risks of asthma symptoms, including wheezing
(overall odds ratio (OR) 1.44 (95%
confidence interval (CI): 1.22, 1.70),
shortness of breath: 1.32 (1.12, 1.56), dry
cough: 1.16 (1.01, 1.34), and persistent
phlegm: 1.30 (1.07, 1.58). The associations
between accelerated infant growth and risk
of developing asthma symptoms were
independent of other fetal growth patterns
and tended to be stronger among children of
atopic mothers.
“Our results suggest that the relationship
between infant weight gain and asthma
symptoms is not due to the accelerated
growth of fetal growth-restricted infants
only,” said Dr. Duijts. “While the
mechanisms underlying this relationship are
unclear, accelerated weight growth in early
life might adversely affect lung growth and
might be associated with adverse changes in
the immune system.”
The study had a few limitations, including
the possibility of measurement error in the
estimation of fetal weight and the use of
self-report for asthma symptoms.
“Further research is needed to replicate our
findings and explore the mechanisms that
contribute to the effects of growth
acceleration in infancy on respiratory
health,” concluded Dr. Duijts. “The effects
of infant growth patterns on asthma
phenotypes in later life should also be
examined.”
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