Influence of childhood growth on asthma and lung function in adolescence

Abstract

Background: Low birth weight and rapid infant growth in early infancy are associated with increased risk of childhood asthma, but little is known about the role of postinfancy growth in asthmatic children.

Objectives: We sought to examine the associations of children's growth patterns with asthma, bronchial responsiveness, and lung function until adolescence.

Methods: Individual growth trajectories from birth until 10 years of age were estimated by using linear spline multilevel models for 9723 children participating in a population-based prospective cohort study. Current asthma at 8, 14, and 17 years of age was based on questionnaires. Lung function and bronchial responsiveness or reversibility were measured during clinic visits at 8 and 15 years of age.

Results: Rapid weight growth between 0 and 3 months of age was most consistently associated with increased risks of current asthma at the ages of 8 and 17 years, bronchial responsiveness at age 8 years, and bronchial reversibility at age 15 years. Rapid weight growth was associated with lung function values, with the strongest associations for weight gain between 3 and 7 years of age and higher forced vital capacity (FVC) and FEV1 values at age 15 years (0.12 [95% CI, 0.08 to 0.17] and 0.11 [95% CI, 0.07 to 0.15], z score per SD, respectively) and weight growth between 0 and 3 months of age and lower FEV1/FVC ratios at age 8 and 15 years (-0.13 [95% CI, -0.16 to -0.10] and -0.04 [95% CI, -0.07 to -0.01], z score per SD, respectively). Rapid length growth was associated with lower FVC and FVC1 values at age 15 years.

Conclusion: Faster weight growth in early childhood is associated with asthma and bronchial hyperresponsiveness, and faster weight growth across childhood is associated with higher FVC and FEV1 values.

Keywords: ALSPAC; asthma; cohort study; growth; lung function.

Fig E1

Flow chart of participants in the study.

Fig 1

Growth (height and weight) with lung function measures of FVC (A and B), FEV₁ (C and D), FEF_25-75 (E and F), and FEV₁/FVC (G and H) and FEF_25-75/FVC (I and J) ratios. Values are differences in z score lung function (95% CIs). Z scores were calculated for sex, age, and height at the time of measurement. FEV₁/FVC and FEF_25-75/FVC sex-adjusted z scores were additionally adjusted for age and height of measurement. Models are adjusted for maternal age, education level, body mass index, parity, smoking during pregnancy, anxiety, history of asthma, and the child's sex, gestational age, and breast-feeding duration. Models of weight were additionally adjusted for preceding height and weight growth trajectories, and models of height were additionally adjusted for preceding height growth trajectories and birth weight. Models for lung function at 15 years of age were additionally adjusted for lung function measures at age 8 years.

Fig 1

Growth (height and weight) with lung function measures of FVC (A and B), FEV₁ (C and D), FEF_25-75 (E and F), and FEV₁/FVC (G and H) and FEF_25-75/FVC (I and J) ratios. Values are differences in z score lung function (95% CIs). Z scores were calculated for sex, age, and height at the time of measurement. FEV₁/FVC and FEF_25-75/FVC sex-adjusted z scores were additionally adjusted for age and height of measurement. Models are adjusted for maternal age, education level, body mass index, parity, smoking during pregnancy, anxiety, history of asthma, and the child's sex, gestational age, and breast-feeding duration. Models of weight were additionally adjusted for preceding height and weight growth trajectories, and models of height were additionally adjusted for preceding height growth trajectories and birth weight. Models for lung function at 15 years of age were additionally adjusted for lung function measures at age 8 years.