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Observational Study
. 2023 Sep;10(1):e001895.
doi: 10.1136/bmjresp-2023-001895.

Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya

Helen Meme  1 , Evans Amukoye  2 , Cressida Bowyer  3 , Jeremiah Chakaya  1 , Ruaraidh Dobson  4 , Jonathan Fuld  5 , Cindy M Gray  6 , Richard Kiplimo  1 , Maia Lesosky  7 , Kevin Mortimer  8   9 , Amos Ndombi  1 , Angela Obasi  10   11 , Fred Orina  1 , Jennifer K Quint  12 , Sean Semple  4 , Sarah E West  13 , Lindsey Zurba  14 , Graham Devereux  15
Affiliations
Observational Study

Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya

Helen Meme et al. BMJ Open Respir Res. 2023 Sep.

Abstract

Background: In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance of antenatal and early life factors in the aetiology of asthma and abnormal lung function in children. We present here the first study in sub-Saharan Africa to relate birth characteristics to both childhood respiratory symptoms and lung function.

Methods: Children attending schools in two socioeconomically contrasting but geographically close areas of Nairobi, Kenya, were recruited to a cross-sectional study of childhood asthma and lung function. Questionnaires quantified respiratory symptoms and preterm birth; lung function was measured by spirometry; and parents were invited to bring the child's immunisation booklet containing records of birth weight and serial weights in the first year.

Results: 2373 children participated, 52% girls, median age (IQR), 10 years (8-13). Spirometry data were available for 1622. Child immunisation booklets were available for 500 and birth weight and infant weight gain data were available for 323 and 494 children, respectively. In multivariable analyses, preterm birth was associated with the childhood symptoms 'wheeze in the last 12 months'; OR 1.64, (95% CI 1.03 to 2.62), p=0.038; and 'trouble breathing' 3.18 (95% CI 2.27 to 4.45), p<0.001. Birth weight (kg) was associated with forced expiratory volume in 1 s z-score, regression coefficient (β) 0.30 (0.08, 0.52), p=0.008, FVC z-score 0.29 (95% CI 0.08 to 0.51); p=0.008 and restricted spirometry, OR 0.11 (95% CI 0.02 to 0.78), p=0.027.

Conclusion: These associations are in keeping with those in HICs and highlight antenatal factors in the aetiology of asthma and lung function abnormalities in sub-Saharan Africa.

Keywords: asthma; asthma epidemiology; paediatric lung disaese.

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Conflict of interest statement

Competing interests: RD has declared employment by the University of Stirling for the duration of the study. JKQ has declared personal funding from GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Chiesi, Teva, Insmed, Bayer and institutional funding from UKRI MRC, Health Data Research UK, GlaxoSmithKline, Bayer, Boehringer Ingelheim, Chiesi, Astra Zeneca and Asthma and Lung UK.

References

    1. Mortimer K, Lesosky M, García-Marcos L, et al. . The burden of asthma, hay fever and eczema in adults in 17 countries: GAN phase I study. Eur Respir J 2022;60:2102865. 10.1183/13993003.02865-2021 - DOI - PMC - PubMed
    1. Global Asthma Network . The global asthma report 2018. Auckland, New Zealand, 2018.
    1. WHO . Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. Jean Bousquet and Nikolai Khaltaev editors, 2007.
    1. Meghji J, Mortimer K, Agusti A, et al. . Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet 2021;397:928–40. 10.1016/S0140-6736(21)00458-X - DOI - PubMed
    1. Meghji J, Nadeau G, Davis KJ, et al. . Noncommunicable lung disease in sub-Saharan Africa a community-based cross-sectional study of adults in urban Malawi. Am J Respir Crit Care Med 2016;194:67–76. 10.1164/rccm.201509-1807OC - DOI - PMC - PubMed

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