title: Fetal and infant growth and asthma symptoms in preschool children: the Generation R Study.
abstract: BACKGROUND
  Low birth weight is associated with an increased risk of wheezing in childhood.
  
  
  OBJECTIVE
  We examined the associations of longitudinally measured fetal and infant growth patterns with the risks of asthma symptoms in preschool children.
  
  
  METHODS
  This study was embedded in a population-based prospective cohort study among 5,125 children. Second- and third-trimester fetal growth characteristics (head circumference, femur length, abdominal circumference, and weight) were estimated by repeated ultrasounds. Infant growth (head circumference, length, and weight) was measured at birth and at the ages of 3, 6, and 12 months. Parental report of asthma symptoms until the age of 4 years was yearly obtained by questionnaires.
  
  
  RESULTS
  Both fetal restricted and accelerated growth, defined as a negative or positive change of more than 0.67 standard deviation score, were not associated with asthma symptoms until the age of 4 years. Accelerated weight gain from birth to 3 months following normal fetal growth was associated with increased risks of asthma symptoms (overall odds ratio for wheezing: 1.44 [95% confidence interval: 1.22, 1.70]; shortness of breath: 1.32 [1.12, 1.56]; dry cough: 1.16 [1.01, 1.34]; persistent phlegm: 1.30 [1.07, 1.58]), but not with eczema (0.95 [0.80, 1.14]). These associations were independent of other fetal growth patterns and tended to be stronger for children of atopic mothers than for children of nonatopic mothers.
  
  
  CONCLUSIONS
  Weight-gain acceleration in early infancy was associated with increased risks of asthma symptoms in preschool children, independent of fetal growth. Early infancy might be a critical period for the development of asthma.
authors.affiliation: The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Agnes M M
authors.initials: AM
authors.lastname: Sonnenschein-van der Voort
authors.forename: Vincent W V
authors.initials: VW
authors.lastname: Jaddoe
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Henriëtte A
authors.initials: HA
authors.lastname: Moll
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Duijts
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D001724:Birth Weight / Q000502:physiology; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D005260:Female; D047109:Fetal Development / Q000502:physiology; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult