title: Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood: A cross-sectional study.
abstract: Maternal prepregnancy obesity has been associated with early wheeze and childhood asthma in their offspring. Some of these studies have been in minority, urban, and disadvantaged populations using parental recall and questionnaires. The association of maternal prepregnancy obesity with bronchodilator dispensing to their offspring, in a primarily insured, non-urban, White population in the United States is unknown.
  
  
  
  We conducted a retrospective cohort study using pharmacy dispensing data from the electronic medical records of a large United States health maintenance organization to examine the relationship between maternal prepregnancy body mass index (BMI) and inhaled bronchodilator dispensing in the offspring to 4 years of age. We included infants ≥37 weeks' gestation with birth weight ≥2.5 kg which yielded 6,194 mother-baby pairs. Maternal prepregnancy BMI was categorized as underweight (<18.5 kg/m(2) ), normal (18.5-24.9 kg/m(2) ), overweight (25-29.9 kg/m(2) ), or obese (≥30 kg/m(2) ).
  
  
  
  In the entire cohort, 27.6% of the offspring received a bronchodilator dispensing. This ranged from 19.2% in the offspring of underweight mothers to 31.3% of those born to obese mothers. In the fully adjusted model using normal BMI as the referent, children of obese mothers had a 22% higher rate of bronchodilator dispensing (adjusted OR = 1.22; 95%CI 1.05-1.41; P = 0.008).
  
  
  
  In this insured, non-urban, White population, maternal prepregnancy obesity was associated with bronchodilator dispensing in the offspring in early life. These results extend previous data and reaffirm the potential widespread public health impact that prepregnancy obesity may have on subsequent childhood respiratory health. Pediatr Pulmonol. 2016;51:803-811. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon.
authors.forename: Kelvin D
authors.initials: KD
authors.lastname: MacDonald
authors.affiliation: Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon.
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Vesco
authors.affiliation: Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon.
authors.forename: Kristine L
authors.initials: KL
authors.lastname: Funk
authors.affiliation: Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon.
authors.forename: Jerena
authors.initials: J
authors.lastname: Donovan
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon.
authors.forename: Thuan
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon.
authors.forename: Zunqiu
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon.
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Lapidus
authors.affiliation: Kasier Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, Oregon.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.affiliation: Oregon Health and Science University, 3181 SW Sam Jackson Road, Portland, Oregon.
authors.forename: Cindy T
authors.initials: CT
authors.lastname: McEvoy
mesh_terms: D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D015992:Body Mass Index; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009765:Obesity / Q000150:complications* / Q000208:ethnology; D050177:Overweight / Q000150:complications / Q000208:ethnology; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D013851:Thinness / Q000150:complications / Q000208:ethnology; D014481:United States; D044465:White People
chemical_list: D001993:Bronchodilator Agents
keywords: bronchodilator; maternal obesity; pediatrics; wheeze