title: Maternal obesity in pregnancy, gestational weight gain, and risk of childhood asthma.
abstract: OBJECTIVE
  Environmental or lifestyle exposures in utero may influence the development of childhood asthma. In this meta-analysis, we aimed to assess whether maternal obesity in pregnancy (MOP) or increased maternal gestational weight gain (GWG) increased the risk of asthma in offspring.
  
  
  METHODS
  We included all observational studies published until October 2013 in PubMed, Embase, CINAHL, Scopus, The Cochrane Database, and Ovid. Random effects models with inverse variance weights were used to calculate pooled risk estimates.
  
  
  RESULTS
  Fourteen studies were included (N = 108 321 mother-child pairs). Twelve studies reported maternal obesity, and 5 reported GWG. Age of children was 14 months to 16 years. MOP was associated with higher odds of asthma or wheeze ever (OR = 1.31; 95% confidence interval [CI], 1.16-1.49) or current (OR = 1.21; 95% CI, 1.07-1.37); each 1-kg/m(2) increase in maternal BMI was associated with a 2% to 3% increase in the odds of childhood asthma. High GWG was associated with higher odds of asthma or wheeze ever (OR = 1.16; 95% CI, 1.001-1.34). Maternal underweight and low GWG were not associated with childhood asthma or wheeze. Meta-regression showed a negative association of borderline significance for maternal asthma history (P = .07). The significant heterogeneity among existing studies indicates a need for standardized approaches to future studies on the topic.
  
  
  CONCLUSIONS
  MOP and high GWG are associated with an elevated risk of childhood asthma; this finding may be particularly significant for mothers without asthma history. Prospective randomized trials of maternal weight management are needed.
authors: Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;University of Pittsburgh Medical School, Pittsburgh, Pennsylvania; erick.forno@chp.edu.
authors: Erick
authors: E
authors: Forno
authors: University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania; and.
authors: Omar M
authors: OM
authors: Young
authors: Division of Allergy and Immunology, Lurie Children's Hospital, Chicago, Illinois.
authors: Rajesh
authors: R
authors: Kumar
authors: University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, Pennsylvania; and.
authors: Hyagriv
authors: H
authors: Simhan
authors: Division of Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;University of Pittsburgh Medical School, Pittsburgh, Pennsylvania;
authors: Juan C
authors: JC
authors: Celedón
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D005260:Female; D006801:Humans; D009035:Mothers; D009765:Obesity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000503:physiopathology; D018570:Risk Assessment; D015430:Weight Gain
keywords: asthma risk factors; childhood asthma; gestational weight gain; maternal obesity; meta-analysis