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Developmental biology - Genes

First 3 years of life affects children's respiratory health

Netherlands study analyzes influence of weight and height on nearly 4,500 children at risk for asthma...


Children's growth in their first three years of life affects their lung development and their risk for asthma by age 10. This is the principal conclusion of a study carried out by the Barcelona Institute for Global Health (ISGlobal), and supported by the "la Caixa" Banking Foundation, and Erasmus University Medical Centre in Rotterdam, The Netherlands.
Early infancy is a critical age for the development of respiratory diseases in childhood and later life. Recent studies reveal excessive weight gain in the first years of life can be associated with lower lung function and a higher risk of childhood asthma.

Published in the journal Thorax, researchers began examining early childhood growth patterns through repeated weight and height measurements during the first three years of a child's life as viewed against any affected respiratory breathing by the age of 10 years. Growth patterns analysed started with height and weight at around one month of age, and body mass index at around nine months of age.

The study tracked 4,435 children in the Netherlands participating in the Generation R Study. At age 10 years, a common office test, spirometry, assessed how well lungs work by measuring how much air is inhaled, how much is exhaled and how quickly, measuring childrens' lung function. Parents answered a questionnaire to determine whether their child had been diagnosed with asthma by a physician.
"Findings show that infants with the highest weight gain velocity and body mass index had lower lung function at 10 years of age. Specifically, we observed these children had a lower function related to the smaller airways in relation to their total lung volume. Although we did not observe any relationship between height and weight growth and the risk of asthma, this disproportionate development of lung function could be a risk factor for the development of respiratory disease."

Maribel Casas, Erasmus MC, Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; ISGlobal, Barcelona, Spain Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain and lead author of the study.

Abstract
Background Infant weight gain is associated with lower lung function and a higher risk of childhood asthma. Detailed individual childhood growth patterns might be better predictors of childhood respiratory morbidity than the difference between two weight and height measurements. We assessed the associations of early childhood growth patterns with lung function and asthma at the age of 10 years and whether the child’s current body mass index (BMI) influenced any association.

Methods
We derived peak height and weight growth velocity, BMI at adiposity peak, and age at adiposity peak from longitudinally measured weight and height data in the first 3 years of life of 4435 children enrolled in a population-based prospective cohort study. At 10 years of age, spirometry was performed and current asthma was assessed by questionnaire. Spirometry outcomes included forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, and forced expiratory flow after exhaling 75% of vital capacity (FEF75).

Results
Greater peak weight velocity was associated with higher FVC but lower FEV1/FVC and FEF75. Greater BMI at adiposity peak was associated with higher FVC and FEV1 but lower FEV1/FVC and FEF75. Greater age at adiposity peak was associated with higher FVC, FEV1, FEV1/FVC and FEF75, particularly in children with a small size at birth, and lower odds of current asthma in boys. The child’s current BMI only explained the associations of peak weight velocity and BMI at adiposity peak with FVC and FEV1. Peak height velocity was not consistently associated with impaired lung function or asthma.

Conclusion
Peak weight velocity and BMI at adiposity peak were associated with reduced airway patency in relation to lung volume, whereas age at adiposity peak was associated with higher lung function parameters and lower risk of asthma at 10 years, particularly in boys.

Authors
Maribel Casas, Herman T. den Dekker, Claudia J. Kruithof, Irwin K Reiss, Martine Vrijheid, Jordi Sunyer, Johan C. de Jongste, Vincent W. V. Jaddoe, and Liesbeth Duijts.


Funding
The Generation R Study is made possible by financial support from the Erasmus Medical Centre, Rotterdam, Erasmus University Rotterdam and the Netherlands Organization for Health Research and Development. Dr Liesbeth Duijts received additional funding from the European Union’s Horizon 2020 co-funded programme ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL) (ALPHABET project (no. 696295; 2017), ZonMW The Netherlands (no. 529051014; 2017)). The study was supported by the Netherlands Organization for Health Research and Development (VIDI 016.136.361), a European Research Council Consolidator Grant (ERC-2014-CoG-648916), funding from the European Union’s Seventh Framework Programme under grant agreement no. 289346 (EarlyNutrition), and funding from the European Union’s Horizon 2020 research and innovation programme under grant agreements no. 733206 (LifeCycle) and no. 633595 (DynaHEALTH). Dr Maribel Casas received funding from Instituto de Salud Carlos III (Ministry of Economy and Competitiveness) (CD12/00563 and MS16/00128). The researchers are independent from the funders. Disclaimer The study sponsors had no role in the study design, data collection, data analysis, interpretation of data, and preparation, review or approval of the manuscript.

Competing interests None declared.

Patient consent Parental/guardian consent obtained.

The authors declare no competing financial interests.


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Sep 7, 2018   Fetal Timeline   Maternal Timeline   News   News Archive




A new study analyzes the influence of weight and height on lung development and asthma risk
in nearly 4,500 children in Rotterdam (Netherlands). Photo by Charlein Gracia.


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