Birth-related factors and doctor-diagnosed wheezing and allergic sensitization in early childhood

Authors


  • Edited by: Hans-Uwe Simon

Leea Keski-Nisula, Environmental Health Department, National Institute for Health and Welfare, PL 95, 70701 Kuopio, Finland.
Tel.: 358 20 610 6325
Fax: 358 20 610 6498
E-mail: leea.keski-nisula@kuh.fi; leea.keski-nisula@thl.fi

Abstract

To cite this article: Keski-Nisula L, Karvonen A, Pfefferle PI, Renz H, Büchele G, Pekkanen J. Birth-related factors and doctor-diagnosed wheezing and allergic sensitization in early childhood. Allergy 2010; 65: 1116–1125.

Abstract

Background:  To investigate the associations between clinical obstetric factors during birth and doctor-diagnosed wheezing and allergic sensitization during early childhood.

Methods:  We followed 410 Finnish women from late pregnancy until 18 months age of their children. All children were delivered at term. Doctor-diagnosed wheezing among children was established by questionnaires, while specific immunoglobulin E antibodies to inhalant and food allergens were measured in 388 children at 1 year of age. Data on maternal obstetric variables were recorded at the time of delivery.

Results:  Children of mothers with longer duration of ruptured fetal membranes before birth had significantly higher risk of doctor-diagnosed wheezing during early childhood compared to those children with shorter period of ruptured fetal membranes (III vs I quartile; aOR 6.65, 95% CI 1.99–22.18; P < 0.002 and IV vs I quartile; aOR 3.88, 95% CI 1.05–14.36, P < 0.043). Children who were born by Cesarean delivery had significantly less allergic sensitization at the age of 1 year compared to those who were born by vaginal route (16.0%vs 32.2%; aOR 0.34, 95% CI 0.14–0.80; P < 0.013). Furthermore, allergic sensitization tended to be more common in children with longer duration of labor before birth. No other birth-related obstetric factors, such as induction, the type of fetal membrane rupture during birth or quality of amniotic fluid were associated significantly with the examined outcomes.

Conclusion:  The longer duration of the ruptured fetal membranes possibly reflected the higher risk of intrapartum infection at birth, and further increased the risk of doctor-diagnosed wheezing among offspring.

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