Foetal and childhood growth and asthma in adult life

Authors

  • David JP Barker,

    Corresponding author
    1. MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
    2. Chair of Fetal Programming, King Saud University, Riyadh, Saudi Arabia
    • Heart Research Center, Oregon Health and Science University, Portland, OR, USA
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  • Clive Osmond,

    1. MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
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  • Tom J Forsén,

    1. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
    2. Vasa Health Care Centre, Vasa, Finland
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  • Kent L Thornburg,

    1. Heart Research Center, Oregon Health and Science University, Portland, OR, USA
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  • Eero Kajantie,

    1. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
    2. Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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  • Johan G Eriksson

    1. Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
    2. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
    3. Folkhälsan Research Centre, Helsinki, Finland
    4. Unit of General Practice, Helsinki University Central Hospital, Helsinki, Finland
    5. Vasa Central Hospital, Vasa, Finland
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Correspondence

Prof DJP Barker, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. Tel: +44 (0) 2380 777624 | Fax: +44 (0) 2380 704021 | Email: djpbarker@gmail.com

Abstract

Aim

Recent research suggests that asthma may originate through defects in the airway epithelium, acquired in utero, and an altered response to infections after birth. Here, we examine whether asthma in adult life is associated with reduced body size at birth and poor living conditions in childhood.

Methods

We studied 658 people taking medication for asthma in a cohort of 13 345 men and women born in Helsinki, Finland, during 1934–1944. Their body and placental size at birth, and their living conditions and growth in childhood, had been recorded.

Results

The odds ratios for asthma were 0.93 (95% CI 0.89–0.97, p = 0.001) per cm increase in birth length and 0.92 (0.89–0.96, p < 0.001) per cm increase in the length of placental surface. After allowing for size at birth, growth during childhood was unrelated to asthma. People who were born into families of low socio-economic status were at increased risk of later asthma.

Conclusion

Slow linear growth in utero, which could be a result of impaired placentation, increases the risk of later asthma. Slow linear growth may be associated with impaired development of the airways. Babies with impaired lung development born into families of low socio-economic status may be most vulnerable to the disease.

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