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Effects of intrauterine growth restriction and postnatal nutrition on pediatric asthma in Bangladesh

Published online by Cambridge University Press:  07 March 2019

Y. Nozawa ,
M. D. H. Hawlader ,
F. Ferdous ,
R. Raqib ,
F. Tofail ,
E.-C. Ekström  and
Y. Wagatsuma
Y. Nozawa
Affiliation:
Department of Clinical Trial and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
M. D. H. Hawlader
Affiliation:
Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
F. Ferdous
Affiliation:
Department of Clinical Trial and Clinical Epidemiology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
R. Raqib
Affiliation:
International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
F. Tofail
Affiliation:
International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
E.-C. Ekström
Affiliation:
Department of Women’s and Children’s Health, International Maternal and Child Health Uppsala University, Uppsala, Sweden
Y. Wagatsuma*
Affiliation:
Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
*
Address for correspondence: Y. Wagatsuma, Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan. E-mail: ywagats@md.tsukuba.ac.jp
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Abstract

Numerous studies have investigated the risk of developing asthma due to early-life experiences and environmental exposures. However, the influence of intrauterine growth restriction and postnatal undernutrition on childhood wheezing/asthma remains unclear. Thus, we examined the effects of both small for gestational age (SGA) and postnatal stunted growth on ever asthma among children in the rural areas in Bangladesh.

Multiple follow-up studies were conducted in a cohort of randomized clinical trial of nutrition interventions during pregnancy (the MINIMat trial). Overall, 1208 and 1697 children were followed-up for asthma at 4.5 and 10 years, respectively. Anthropometric measurements were obtained at various intervals from birth to 10 years of age. Ever asthma was identified using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.

Results showed that SGA was significantly associated with increased risk of ever asthma at 4.5 and 10 years after adjusting for sex, body mass index, socioeconomic status, family history of asthma, gestational age at birth, mother’s parity, mother’s age at birth and intervention trial arm [odds ratio (OR)=1.97 (95% confidence interval (CI): 1.34–2.90) and 1.86 (95% CI: 1.18–2.72)]. For the postnatal effect of undernutrition, stunting at 1 and 2 years was significantly associated with ever asthma at 4.5 and 10 years [1 year: OR=1.77 (95% CI: 1.22–2.57) and OR=1.72 (95% CI: 1.16–2.56), 2 years: OR=1.49 (95% CI: 1.06–2.10) and OR=1.41 (95% CI: 1.02–1.96)].

In conclusion, SGA and undernutrition during infancy has an influence on childhood asthma among children in Bangladesh, indicating the need for nutritional interventions early in life.

Keywords

asthmaBangladeshintrauterine growth restrictionsmall for gestational agestunting
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Issue 6 , December 2019 , pp. 627 - 635
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019 

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