Respiratory symptoms in the first 7 years of life and birth weight at term: the PIAMA Birth Cohort.
BACKGROUND
The relation between birth weight and respiratory symptoms and asthma in children remains unclear. Previous studies focused on a relation at separate ages. A longitudinal analysis may lead to a better understanding.


OBJECTIVE
To estimate the effect of birth weight on the development and course of respiratory symptoms and asthma in the first 7 years of life.


METHODS
In a prospective birth cohort study, 3,628 children with a gestational age 37 weeks or more were monitored for 7 years. Parental questionnaires were used to assess respiratory health yearly. Associations of birth weight with respiratory symptoms (wheezing, coughing, respiratory infections) and doctor's diagnosis of asthma were assessed in a repeated-event analysis.


RESULTS
Lower birth weight was associated with more respiratory symptoms (odds ratio [OR] per kg decrease in birth weight, 1.21; 95% confidence interval [CI], 1.09-1.34). The effect of birth weight increased from age 1 to 5, but decreased thereafter and was no longer significant at the age of 7. The effect of birth weight on respiratory symptoms was significantly greater among children exposed to tobacco smoke in their home than among nonexposed children (OR at 5 yr: 1.21 [95% CI, 1.02-1.44] and 1.52 [95% CI, 1.23-1.87], respectively). Birth weight and a doctor's diagnosis of asthma were not related (OR, 1.06; 95% CI, 0.82-1.37).


CONCLUSIONS
A lower birth weight in children born at term is associated with a transiently increased risk of respiratory symptoms. This effect is enhanced by environmental tobacco smoke exposure.
Caudri
Daan
D
Department of Pediatrics/Respiratory Medicine, Erasmus University, 3000 CB Rotterdam, The Netherlands.
Wijga
Alet
A
Gehring
Ulrike
U
Smit
Henriette A
HA
Brunekreef
Bert
B
Kerkhof
Marjan
M
Hoekstra
Maarten
M
Gerritsen
Jorrit
J
de Jongste
Johan C
JC
D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D001724:Birth Weight; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis; D066298:In Vitro Techniques; D015994:Incidence; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D012120:Respiration Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012737:Sex Factors; D014028:Tobacco Smoke Pollution
D014028:Tobacco Smoke Pollution