The association between prenatal F2-isoprostanes and child wheeze/asthma and modification by maternal race

Abstract

Background: Childhood wheeze, asthma, and allergic rhinitis are common and likely have prenatal origins. Oxidative stress is associated with respiratory disease, but the association of oxidative stress during the prenatal period with development of respiratory and atopic disease in childhood, particularly beyond the infancy period, is unknown. This study aims to investigate associations between prenatal oxidative stress, measured by maternal urinary F₂-isoprostanes, and child respiratory outcomes, including effect modification by maternal race.

Methods: We prospectively studied Black (n = 717) and White (n = 363) mother-child dyads. We measured F₂-isoprostanes in 2nd-trimester urine (ng/mg-creatinine). At approximately age 4, we obtained parent report of provider-diagnosed asthma (ever), current wheeze, current asthma (diagnosis, symptoms and/or medication), and current allergic rhinitis (current defined as previous 12 months). We used multivariable logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) per interquartile range (IQR) increase in F₂-isoprostane concentration, controlling for confounders. We examined modification by maternal race using interaction terms.

Results: The prevalence of provider-diagnosed asthma and current wheeze, asthma and allergic rhinitis was 14%, 19%, 15%, and 24%, respectively. Median (IQR) F_2-isoprostane levels were 2.1 (1.6, 2.9) ng/mg-creatinine. Associations between prenatal F₂-isoprostanes and provider-diagnosed asthma, current wheeze, and current asthma were modified by maternal race. Results were strongest for current wheeze (aOR [95%CI]: 1.55 [1.16, 2.06] for White; 0.98 [0.78, 1.22] for Black; p-interaction = 0.01). We observed no association between F_2-isoprostanes and allergic rhinitis.

Conclusion: Prenatal urinary F₂-isoprostanes may be a marker associated with childhood wheeze/asthma in certain populations. Research is needed to understand underlying mechanisms and racial differences.

Keywords: Allergic rhinitis; Asthma; Isoprostane; Oxidative stress; Pediatric; Prenatal; Wheezing.

Figure 1.

Adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for asthma and allergic rhinitis outcomes per interquartile range (IQR) increase in maternal urinary F₂-isoprostane (ng/mg-creatinine) (IQR: 1.59, 2.87) for the overall model and model with F₂-isoprostane * maternal race interaction term; p-interaction (p-int) corresponds to the p-value for the interaction term.