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Maternal Prepregnancy Obesity is an Independent Risk Factor for Frequent Wheezing in Infants by Age 14 Months

Authors

  • Stefano Guerra,

    Corresponding author
    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
    4. Arizona Respiratory Center, University of Arizona, Tucson, AZ
      Stefano Guerra, Centre for Research in Environmental Epidemiology, Doctor Aiguader, 88, 08003 Barcelona, Spain. E-mail: sguerra@creal.cat
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  • Claudio Sartini,

    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
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  • Michelle Mendez,

    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
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  • Eva Morales,

    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
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  • Mònica Guxens,

    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
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  • Mikel Basterrechea,

    1. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
    2. Subdirección de Salud Pública de Gipuzkoa, Department of Health of the Basque Government, San Sebastián
    3. Health Research Institute Biodonostia, San Sebastián
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  • Leonor Arranz,

    1. Hospital Donostia, Basque Health Service (Osakidetza), San Sebastián
    2. University of Basque Country (EHU-UPV), San Sebastián, Spain
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  • Jordi Sunyer

    1. Centre for Research in Environmental Epidemiology
    2. Hospital del Mar Research Institute (IMIM)
    3. Universitat Pampeu Fabra, Barcelona
    4. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona
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Stefano Guerra, Centre for Research in Environmental Epidemiology, Doctor Aiguader, 88, 08003 Barcelona, Spain. E-mail: sguerra@creal.cat

Abstract

Background:  Maternal prepregnancy obesity has been linked to the offspring's risk for subsequent asthma. We determined whether maternal obesity is associated with increased risk of wheezing phenotypes early in life.

Methods:  We used data on 1107 mother–child pairs from two birth cohorts from the INMA–INfancia y Medio Ambiente project. Maternal height was measured and prepregnancy weight self-reported at enrolment (on average at 13.7 ± 2 weeks of gestation). Maternal prepregnancy body mass index was categorised as underweight, normal, overweight and obese according to WHO recommendations. Information on child's wheezing was obtained through questionnaires up to the age of 14 (±1) months. Wheezing was classified as infrequent (<4 reported wheezing episodes) or frequent (≥4 episodes). Weight and length of infants were measured by trained study staff at 14.6 (±1) months of age and weight-for-length z-scores computed.

Results:  Although maternal obesity did not increase the risk of the child to have any or infrequent wheezing, children of obese mothers were more likely to have frequent wheezing than children of normal-weight mothers (11.8% vs. 3.8%; P = 0.002). In fully adjusted multinomial logistic regression models, including infants' weight-for-length z-scores and other covariates, maternal prepregnancy obesity was associated with increased risk of frequent [adjusted relative risk (RR) 4.18, 95% confidence interval (CI) 1.55, 11.3] but not infrequent (RR 1.05 [95% CI 0.55, 2.01]) wheezing in their children.

Conclusions:  Maternal prepregnancy obesity is independently associated with an increased risk of frequent wheezing in the infant by the age of 14 months. These findings add evidence on the potential effects of in utero exposures on asthma-related phenotypes.

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