Maternal Obesity in Pregnancy, Gestational Weight Gain, and Risk of Childhood Asthma

Abstract

BACKGROUND AND 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/m2 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.

The Neonatal Methylome as a Gatekeeper in the Trajectory to Childhood Asthma

“…A meta-analysis of 14 studies and 108,321 mother-child pairs showed that maternal overweight or obesity in pregnancy was associated with increased risks of childhood asthma or wheeze ever (OR 1.31, 95% CI 1.16, .49) and current asthma or wheeze (1.21, 1.07, .37), independent of offspring body mass index (BMI) [38]. The studies that explored the links between maternal obesity and DNA methylation in the offspring are somewhat inconsistent in their results but point to an association between maternal BMI and neonatal DNA methylation at a limited number of CpG sites.…”

In utero Programming of Allergic Susceptibility

“…The most recent meta-analysis of 14 high-quality studies reported that children are 30-50% more likely to develop asthma or wheeze when mothers are obese at conception compared to the children of mothers with a normal body mass index (BMI; online suppl. table 1) [33]. Although maternal BMI in the obese range is clearly associated with a greater likelihood of asthma or wheeze in children, maternal overweight was not identified as a statistically significant determinant.…”

Childhood Health Consequences of Maternal Obesity during Pregnancy: A Narrative Review

“…A meta-analysis among 14 European birth cohort studies showed that maternal overweight and obesity during pregnancy were associated with the risk of ever wheezing and recurrent wheezing until the age of 2 years [42] . Accordingly, a more recent meta-analysis among 14 studies with over 108,000 mother-child pairs showed that maternal obesity during pregnancy was associated a 31% increased risk of asthma or ever wheezing in children aged 14 months to 16 years [43] . Each 1-kg/m 2 increase in maternal BMI led to a 3% increased risk of childhood asthma [43] .…”

“…Accordingly, a more recent meta-analysis among 14 studies with over 108,000 mother-child pairs showed that maternal obesity during pregnancy was associated a 31% increased risk of asthma or ever wheezing in children aged 14 months to 16 years [43] . Each 1-kg/m 2 increase in maternal BMI led to a 3% increased risk of childhood asthma [43] . High gestational weight gain was associated with a 16% higher risk of ever asthma or wheezing, but not with current asthma or wheeze [43] .…”