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. 2016 Aug;51(8):803-11.
doi: 10.1002/ppul.23384. Epub 2016 Jan 21.

Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood: A cross-sectional study

Kelvin D MacDonald  1 , Kimberly K Vesco  2 , Kristine L Funk  2 , Jerena Donovan  2 , Thuan Nguyen  1 , Zunqiu Chen  1 , Jodi A Lapidus  1 , Victor J Stevens  2 , Cindy T McEvoy  1
Affiliations

Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood: A cross-sectional study

Kelvin D MacDonald et al. Pediatr Pulmonol. 2016 Aug.

Abstract

Rationale: Maternal prepregnancy obesity has been associated with early wheeze and childhood asthma in their offspring. Some of these studies have been in minority, urban, and disadvantaged populations using parental recall and questionnaires. The association of maternal prepregnancy obesity with bronchodilator dispensing to their offspring, in a primarily insured, non-urban, White population in the United States is unknown.

Objectives and methods: We conducted a retrospective cohort study using pharmacy dispensing data from the electronic medical records of a large United States health maintenance organization to examine the relationship between maternal prepregnancy body mass index (BMI) and inhaled bronchodilator dispensing in the offspring to 4 years of age. We included infants ≥37 weeks' gestation with birth weight ≥2.5 kg which yielded 6,194 mother-baby pairs. Maternal prepregnancy BMI was categorized as underweight (<18.5 kg/m(2) ), normal (18.5-24.9 kg/m(2) ), overweight (25-29.9 kg/m(2) ), or obese (≥30 kg/m(2) ).

Results: In the entire cohort, 27.6% of the offspring received a bronchodilator dispensing. This ranged from 19.2% in the offspring of underweight mothers to 31.3% of those born to obese mothers. In the fully adjusted model using normal BMI as the referent, children of obese mothers had a 22% higher rate of bronchodilator dispensing (adjusted OR = 1.22; 95%CI 1.05-1.41; P = 0.008).

Conclusions: In this insured, non-urban, White population, maternal prepregnancy obesity was associated with bronchodilator dispensing in the offspring in early life. These results extend previous data and reaffirm the potential widespread public health impact that prepregnancy obesity may have on subsequent childhood respiratory health. Pediatr Pulmonol. 2016;51:803-811. © 2016 Wiley Periodicals, Inc.

Keywords: bronchodilator; maternal obesity; pediatrics; wheeze.

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Conflict of interest statement

The authors all report no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Cohort selection process for pregnancies beginning and ending between 2000 and 2005 (*only first pregnancy episode included for women with more than one pregnancy in the study period)
See this image and copyright information in PMC

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