Familial Factors Do not Confound the Association Between Birth Weight and Childhood Asthma
Familial Factors Do not Confound the Association Between Birth Weight and Childhood Asthma
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DOI：
10.1542/peds.2009-0305
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发表时间：
2009-10-01
期刊：
影响因子：
8
通讯作者：
Almqvist, Catarina
中科院分区：
文献类型：
--
作者：
Ortqvist, Anne Kristina;Lundholm, Cecilia;Almqvist, Catarina
目的：研究发现低出生体重与哮喘之间存在关联。然而，这种关联可能是由于家族混杂。我们的目的是调查是否胎儿生长和出生体重影响哮喘的风险在儿童期，控制胎龄（GA），和共享（家庭）环境和遗传factors. PATIENTAND方法：哮喘，接合性，出生特征和潜在的混杂因素的信息收集所有9- 12岁的双胞胎通过瑞典双胞胎登记和医学出生登记。为了获得出生体重对哮喘风险的总体影响，我们对所有双胞胎（N = 10918）进行了队列分析。为了解决遗传和共享的环境混杂，我们进行了一个共同的双胞胎对照分析，使用157个同卵和289个异卵的同性双胞胎对谁是不一致的哮喘。结果：哮喘的总发病率为13.7%。在队列分析中，与出生体重减少1000 g相关的哮喘校正比值比（OR）为1.57（95%置信区间[CI]：1.38-1.79），每减少一个孕周，OR为1.10（95% CI：1.07-1.13）。在双胞胎对照分析中，出生体重下降1000 g对应的OR为1.25（95% CI：0.74-2.10）对于异卵同性双胞胎和2.42（95%CI：1.00-5.88）。结论：胎儿生长与儿童哮喘之间存在着独立于GA的联系，（家族）环境和遗传因素，这表明胎儿生长受限影响肺发育，支持对儿童哮喘早期代谢和生理机制的进一步研究。儿科2009; 124：e737-e743
OBJECTIVE: Studies have found associations between low birth weight and asthma. However, this association could be due to familial confounding. Our objective was to investigate whether fetal growth and birth weight affect the risk of asthma in childhood, controlling for gestational age (GA), and shared (familial) environment and genetic factors.PATIENT AND METHODS: Information on asthma, zygosity, birth characteristics, and potential confounders was collected for all 9- and 12-year-old twins through the Swedish Twin Register and Medical Birth Register. To obtain an overall effect of birth weight on risk of asthma, we performed cohort analyses on all twins (N = 10 918). To address genetic and shared environmental confounding, we performed a co-twin control analysis by using the 157 monozygotic and 289 dizygotic same-sex twin pairs who were discordant for asthma.RESULTS: The overall rate of asthma ever was 13.7%. In the cohort analysis, the adjusted odds ratio ( OR) for asthma in relation to a 1000-g decrease in birth weight was 1.57 (95% confidence interval [CI]: 1.38-1.79), and for each reduced gestational week the OR was 1.10 ( 95% CI: 1.07-1.13). In the co-twin control analyses, a 1000-g decrease in birth weight corresponded to an OR of 1.25 ( 95% CI: 0.74-2.10) for dizygotic same-sex twins and 2.42 ( 95% CI: 1.00-5.88) for monozygotic twins.CONCLUSIONS: There is an association between fetal growth and childhood asthma that is independent of GA and shared ( familial) environment and genetic factors, which indicates that fetal growth restriction affects lung development, supporting additional studies on the early metabolic and physiologic mechanisms of childhood asthma. Pediatrics 2009; 124: e737-e743