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a Wellington Asthma
Research Group, Department of Medicine, Wellington School of Medicine,
P.O. Box 7343, Wellington, New Zealand, b Firestone Regional Chest and Allergy Unit, St
Joseph's Hospital-McMaster University, Hamilton, Ontario L8N4A6,
Canada, c Department of
Paediatrics, d Department
of Medicine, e Department of
Preventive Medicine, f Otago
Medical School, P.O. Box 913, Dunedin, New Zealand
Correspondence to: Dr P Leadbitter.
Received 4 January 1999; Returned to authors 29 March 1999; Revised version received 15 June 1999; Accepted for publication 1 July 1999
BACKGROUND
A study was
undertaken to investigate the relationship between birth anthropometric
measures and the subsequent development of asthma, airway
hyperresponsiveness, and atopy in later childhood.
METHODSA longitudinal
study was performed on 734 subjects (71%) from a cohort of children
born in Dunedin, New Zealand in 1972-73. The birth anthropometric
measures were available from hospital records and the main outcome
measures of reported asthma, skin prick tests, and methacholine
hyperresponsiveness were measured at the age of 13 years, while the
serum total IgE was measured at 11 years.
RESULTSAfter
adjustment for other factors, infants with a larger head circumference
at birth tended to have higher serum total IgE at 11 years of age (p = 0.02) but IgE was not associated significantly with birth length or
birth weight. The adjusted odds ratio for raised serum IgE
(>150 IU/ml) in infants with a head circumference of 37 cm or more
was 3.4 (95% CI 1.4 to 7.9). In contrast, recent asthma symptoms were
positively associated with birth length (p = 0.04) but not with head
circumference. The adjusted odds ratio for asthma in the previous two
years in infants with a birth length of 56 cm or more was 6.4 (95% CI
2.0 to 19.8). Infants with a birth weight of less than 3.0 kg had an
odds ratio for reported asthma of 0.2 (95% CI 0.0-0.6). There were no
significant associations of any of the birth parameters with skin prick
positivity, reported hay fever, or eczema.
CONCLUSIONSThese
results suggest that increased fetal growth is related to an increased
risk of asthma and atopy in childhood. The precision of the findings is
limited by the small numbers in the extreme categories of each birth
parameter, but the results are consistent with intrauterine
programming of the developing respiratory and immune systems.
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