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Maternal obesity and inhaled corticosteroid use in childhood

Adrian Lowe, Cecilia Ekeus, Lennart Bråbäck, Kristiina Rajaleid, Anders Hjern
European Respiratory Journal 2012 40: 1369; DOI:
Adrian Lowe
1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
2Respiratory Diseases Group, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
3School of Population Health, University of Melbourne, Australia
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Cecilia Ekeus
4Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden
5Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden
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Lennart Bråbäck
1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
6Department of Research and Development, Västernorrland County Council, Sundsvall, Sweden
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Kristiina Rajaleid
5Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden
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Anders Hjern
5Centre for Health Equity Studies (CHESS), Karolinska Institutet/Stockholm University, Stockholm, Sweden
7Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden
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Abstract

Background: It has been proposed that maternal obesity during pregnancy may increase the risk that the child develops asthma and allergic disease, although the mechanisms underpinning this relationship are currently unclear.

Methods: The study population comprised a Swedish national cohort of term children born between 1992 and 2008 to native Swedish parents. Maternal BMI was measured at 8-10 weeks gestation. Unconditional logistic regression models were used to determine if maternal obesity was associated with increased risk of inhaled corticosteroid (ICS) in 431,718 first-born children, while adjusting for potential confounders. An age-matched discordant sib-pair analysis was performed for 38,296 children, taking into account shared genetic and environmental risk factors.

Results: Maternal over-weight and obesity were associated with increased risk that the child would require ICS (for BMI >35kg/m2, aOR=1.30, 95%CI=1.10-1.52 compared with normal weight mothers) in children aged 6-12 years. Similar effects were seen in younger children, but in children aged 13-16 years, maternal obesity (BMI>30) was related to increased risk of ICS use in girls (aOR= 1.28, 95%CI=1.07-1.53) but not boys (OR=1.05, 95%CI=0.87-1.26). The sib-pair analysis failed to find any evidence that increasing maternal weight was related to increased risk of ICS use in children older than six years

Conclusion: Maternal obesity is associated with increased risk of childhood ICS use up to approximately 12 years of age, but only in girls after this age. These effects could not be confirmed in a sib pair analysis, suggesting the effects of maternal BMI may be due to shared genetic or environmental risk factors.

  • Asthma - mechanism
  • Infants
  • Public health
  • © 2012 ERS
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Maternal obesity and inhaled corticosteroid use in childhood
Adrian Lowe, Cecilia Ekeus, Lennart Bråbäck, Kristiina Rajaleid, Anders Hjern
European Respiratory Journal Sep 2012, 40 (Suppl 56) 1369;

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Maternal obesity and inhaled corticosteroid use in childhood
Adrian Lowe, Cecilia Ekeus, Lennart Bråbäck, Kristiina Rajaleid, Anders Hjern
European Respiratory Journal Sep 2012, 40 (Suppl 56) 1369;
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