title: Maternal Pre-Pregnancy Obesity and Recurrent Wheezing in Early Childhood.
abstract: A number of studies have linked obesity with asthma in adults and children. Few longitudinal studies have evaluated the effect of maternal pre-pregnancy obesity on either asthma or early childhood respiratory morbidity, and these have not been in urban, nonwhite populations. We sought to determine whether pre-pregnancy obesity was associated with recurrent wheezing in an urban, nonwhite population. This study includes 1,191 children from the Boston Birth Cohort (1998-present) followed prospectively to a mean age of 3.0 ± 2.4 years with study visits aligned with the pediatric primary care schedule. Multivariate logistic regression was used to evaluate the associations of maternal pre-pregnancy obesity (body mass index ≥30) with recurrent wheezing (≥4 lifetime episodes). Secondary outcomes included log-transformed cord-blood immunoglobulin E (Phadia), and physician diagnoses of eczema and food allergy. Pre-pregnancy obesity was present in 20.7% of mothers. Of the 1,191 children, 60 (5%) developed recurrent wheezing. Children of obese mothers had an increased risk of recurrent wheezing (adjusted odds ratio, 95% confidence interval: 3.51, 1.68-7.32). These associations persisted even after adjustment for fetal growth status. In contrast, maternal obesity was not associated with eczema or food allergy, and was inversely associated with log cord-blood immunoglobulin E (β, 95% confidence interval: -0.34, -0.66 to -0.02). In this predominantly urban, multiracial/ethnic birth cohort, maternal pre-pregnancy obesity was associated with an increased risk of recurrent wheezing. This association was not explained by fetal growth or increased atopy. Maternal pre-pregnancy obesity is a prevalent risk factor for respiratory morbidity in this urban, nonwhite population.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Story
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Pongracic
authors.forename: Xiumei
authors.initials: X
authors.lastname: Hong
authors.forename: Lester
authors.initials: L
authors.lastname: Arguelles
authors.forename: Guoying
authors.initials: G
authors.lastname: Wang
authors.forename: Nataliya
authors.initials: N
authors.lastname: Kuptsova-Clarkson
authors.forename: Colleen
authors.initials: C
authors.lastname: Pearson
authors.forename: Kathryn
authors.initials: K
authors.lastname: Ortiz
authors.forename: Anthony
authors.initials: A
authors.lastname: Bonzagni
authors.forename: Stephanie
authors.initials: S
authors.lastname: Apollon
authors.forename: Lingling
authors.initials: L
authors.lastname: Fu
authors.forename: Howard
authors.initials: H
authors.lastname: Bauchner
authors.forename: Xiaobin
authors.initials: X
authors.lastname: Wang