title: First- and second-trimester fetal size and asthma outcomes at age 10 years.
abstract: BACKGROUND
  Greater early fetal size is associated with reduced asthma risk and improved lung function in early childhood.
  
  
  OBJECTIVE
  To test the hypothesis that associations between early fetal size, asthma symptoms, and lung function persist into later childhood.
  
  
  METHODS
  In a longitudinal study, first- and second-trimester fetal measurements were recorded. At 10 years of age a respiratory questionnaire was completed. Spirometry, bronchial challenge, and skin-prick testing were undertaken in a subset.
  
  
  RESULTS
  Fetal measurements were available in the first trimester for 853 individuals and the second trimester for 1,453. Questionnaires were returned for 927 children and 449 underwent detailed phenotyping. For each millimeter increase in first trimester size, asthma risk reduced by 6% (95% confidence interval[CI], 1–11) and FEV1 was higher by an average of 6 ml (95% CI, 1–11).First-trimester size was reduced in those with asthma at both 5 and 10 years compared with early or late onset wheeze (P , 0.02). Compared with persistent high growth in first and second trimesters,persistent low growth was associated with increased asthma risk(odds ratio, 2.8; 95% CI, 1.2–6.9) and a mean reduction in FEV1 of 103 ml (95% CI, 13–194), whereas increasing fetal size was associated with increased eczema risk (odds ratio, 2.5; 95% CI, 1.2–5.3).
  
  
  CONCLUSIONS
  Reduced fetal size from the first trimester is associated with increased risk for asthma and obstructed lung function in childhood. Relative change in size after the first trimester is associated with eczema.
authors.affiliation: Academic Child Health, Obstetrics and Gynaecology, University of Aberdeen, Royal Aberdeen Children’s Hospital, Foresterhill, Aberdeen, UK. s.w.turner@abdn.ac.uk
authors.forename: Steve
authors.initials: S
authors.lastname: Turner
authors.forename: Nanda
authors.initials: N
authors.lastname: Prabhu
authors.forename: Peter
authors.initials: P
authors.lastname: Danielan
authors.forename: Geraldine
authors.initials: G
authors.lastname: McNeill
authors.forename: Leone
authors.initials: L
authors.lastname: Craig
authors.forename: Keith
authors.initials: K
authors.lastname: Allan
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cutts
authors.forename: Peter
authors.initials: P
authors.lastname: Helms
authors.forename: Anthony
authors.initials: A
authors.lastname: Seaton
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
mesh_terms: D001249:Asthma / Q000209:etiology* / Q000503:physiopathology*; D049628:Body Size; D001985:Bronchial Provocation Tests; D002648:Child; D015331:Cohort Studies; D004485:Eczema / Q000209:etiology; D005260:Female; D005333:Fetus / Q000033:anatomy & histology*; D005541:Forced Expiratory Volume; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology; D008171:Lung Diseases / Q000209:etiology; D008297:Male; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D018570:Risk Assessment; D012882:Skin Tests; D013147:Spirometry; D011795:Surveys and Questionnaires; D014797:Vital Capacity