title: Associations between fetal size, maternal {alpha}-tocopherol and childhood asthma.
abstract: BACKGROUND The origins of respiratory disease might be traced back to exposures during fetal life. The aim of the present study was to explore whether there was a relationship between fetal size and respiratory outcomes at 5 years of age in the context of fetal exposure to vitamin E. METHODS A longitudinal birth cohort study was recruited (n=1924). Antenatal ultrasound scan results were identified and the following recorded: crown-rump length (CRL) in the first trimester; femur length (FL) and biparietal diameter (BPD) in the second trimester. Maternal plasma alpha-tocopherol (vitamin E) was measured at the time of the first trimester scan. At 5 years, wheeze and asthma symptoms were reported by questionnaire, and spirometry was measured. RESULTS CRL, spirometry and questionnaire data at 5 years were available for 835, 579 and 1145 individuals, respectively. There were positive associations between CRL and forced expiratory volume in 1 s (FEV(1); 5 ml increase in FEV(1) per mm CRL, p=0.001, n=283), forced vital capacity (FVC; 6 ml increase in FVC per mm CRL, p=0.001) and forced expiratory flow between 25% and 75% of FVC (FEF(25-75); 0.008 ml/s increase in FEF(25-75) per mm CRL, p=0.023), and inverse relationships with CRL and current wheeze (OR 0.59 per CRL quartile, p=0.026, n=547) and asthma (OR 0.55 per CRL quartile p=0.011). CRL was positively associated with maternal plasma alpha-tocopherol (p=0.002). CONCLUSIONS These findings support the concept of very early fetal programming of respiratory disease. Maternal vitamin E status may be one determinant for growth of the fetus and fetal lungs during early pregnancy.
authors.affiliation: Department of Child Health, University of Aberdeen, Royal Aberdeen Children's Hospital, Foresterhill, Aberdeen AB25 2ZG, UK. s.w.turner@abdn.ac.uk
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Turner
authors.forename: Doris
authors.initials: D
authors.lastname: Campbell
authors.forename: Norman
authors.initials: N
authors.lastname: Smith
authors.forename: Leone C A
authors.initials: LC
authors.lastname: Craig
authors.forename: Geraldine
authors.initials: G
authors.lastname: McNeill
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Forbes
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Harbour
authors.forename: Anthony
authors.initials: A
authors.lastname: Seaton
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Helms
authors.forename: Graham S
authors.initials: GS
authors.lastname: Devereux
mesh_terms: D000886:Anthropometry / Q000379:methods; D001249:Asthma / Q000196:embryology* / Q000503:physiopathology; D001724:Birth Weight / Q000502:physiology; D002675:Child, Preschool; D015331:Cohort Studies; D018568:Crown-Rump Length; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005541:Forced Expiratory Volume; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000196:embryology; D007231:Infant, Newborn; D008137:Longitudinal Studies; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D039401:Prenatal Nutritional Physiological Phenomena / Q000502:physiology; D012135:Respiratory Sounds / Q000503:physiopathology; D016216:Ultrasonography, Prenatal; D014797:Vital Capacity; D024502:alpha-Tocopherol / Q000097:blood*
chemical_list: D024502:alpha-Tocopherol