Parental and neonatal risk factors for atopy, airway hyper-responsiveness, and asthma.

Abstract

Background-Previous studies have not resolved the importance of several potential risk factors for the development of childhood atopy, airway hyperresponsiveness, and wheezing, which would allow the rational selection ofinterventions to reduce morbidity from asthma. Risk factors for these disorders were examined in a birth cohort of 1037 New Zealand children. Methods-Responses to questions on respiratory symptoms and measurements of lung function and airway responsiveness were obtained every two to three years throughout childhood and adolescence, with over 85% cohort retention at age 18 years. Atopy was determined by skin prick tests at age 13 years. Relations between parental and neonatal factors, the development of atopy, and features of asthma were determined by comparison of proportions and logistic regression. Results-Male sex was a significant independent predictor for atopy, airway hyper-responsiveness, hay fever, and asthma. A positive family history, especially maternal, of asthma strongly predicted childhood atopy, airway hyperresponsiveness, asthma, and hay fever. Maternal smoking in the last trimester was correlated with the onset of childhood asthma by the age of 1 year. Birth in the winter season increased the risk of sensitisation to cats. Among those with a parental history of asthma or hay fever, birth in autumn and winter also increased the risk of sensitisation to house dust mites. The number of siblings, position in the family, socioeconomic status, and birth weight were not consistently predictive of any characteristic of asthma. Conclusions-Male sex, parental atopy, and maternal smoking during pregnancy are risk factors for asthma in young children. Children born in winter exhibit a greater prevalence of sensitisation to cats and house dust mites. These data suggest possible areas for intervention in children at risk because of parental atopy. (Arch Dis Child 1996;75:392-398)

A case‐control study of risk factors for asthma in New Zealand children

“…5,7,8,26,30 Fergusson, in a New Zealand cohort study, found that the association between parental asthma and asthma in four-year-old children was true for boys but not girls, and concluded that the expression of asthma in genetically susceptible female children is delayed until middle childhood compared with its earlier expression in genetically susceptible boys. 8 The older age (7-9 years) of the children in our study may explain why we did not find such clear gender differences in the association between parental asthma and childhood asthma.…”

“…3,4 Prevalence studies in New Zealand 3,5,6 have identified various risk factors for childhood asthma, including male sex, 5,7 parental 3,5,6 or sibling asthma, 6 or having eczema during the first year of life. 6 However, there have also been inconsistent findings among these studies, including reports that paternal asthma 5 and parental eczema 6 are not significantly related to asthma in the child, and that the influence of parental asthma may depend on a child's gender. 8 More recently, a role for vaccination in promoting allergic sensitisation has been proposed.…”

Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

“…Common manifestations of allergic disease include allergic rhinitis or hay fever, asthma, eczema or atopic dermatitis, and food allergies. The risk of allergic disease is increased to about 1 in 3 if one first degree relative (parent or sibling) is atopic and to 70% if both parents are atopic [4]. The pattern of allergy expression differs with age, with the greatest incidence of food allergy and atopic eczema peaking by 1 year of age while asthma and allergic rhinitis continue to rise until around 15 years of age [5].…”

Induction of a disintegrin and metalloprotease 33 during embryonic lung development and the influence of IL-13 or maternal allergy

“…Influence of an allergic maternal environment on Adam33 mRNA and Adam33 protein expression in the lungs of offspring Maternal atopy is a strong risk factor for developing BHR and asthma 18,21,22 early in life. To investigate the impact of maternal allergy on Adam33 expression, we used A/J mice (Bhr1 locuspositive).…”

“…1,8,9 However, a soluble form of ADAM33 (sADAM33) has been identified in bronchoalveolar lavage (BAL) fluid from subjects with asthma, where its levels are inversely correlated with lung function. 10 ADAM33/Adam33 is a member of the multifunctional ADAM family of Zn 21 -dependent metalloproteases. The protein is composed of the signal sequence, pro-, metalloprotease-, disintegrin-, cysteine-rich-, epidermal growth factor-like-, transmembrane-, and cytoplasmic domains, to which specific functions have been attributed.…”