Associations between fetal size, maternal alpha-tocopherol and childhood asthma

作者：Turner Stephen W^*; Campbell Doris; Smith Norman; Craig Leone C A; McNeill Geraldine; Forbes Sarah H; Harbour Paul J; Seaton Anthony; Helms Peter J; Devereux Graham S

来源：Thorax, 2010, 65(5): 391-397.

DOI：10.1136/thx.2008.111385

Background The origins of respiratory disease might be traced back to exposures during fetal life. The aim of the present study was to explore whether there was a relationship between fetal size and respiratory outcomes at 5 years of age in the context of fetal exposure to vitamin E.
Methods A longitudinal birth cohort study was recruited (n = 1924). Antenatal ultrasound scan results were identified and the following recorded: crown-rump length (CRL) in the first trimester; femur length (FL) and biparietal diameter (BPD) in the second trimester. Maternal plasma alpha-tocopherol (vitamin E) was measured at the time of the first trimester scan. At 5 years, wheeze and asthma symptoms were reported by questionnaire, and spirometry was measured.
Results CRL, spirometry and questionnaire data at 5 years were available for 835, 579 and 1145 individuals, respectively. There were positive associations between CRL and forced expiratory volume in 1 s (FEV(1); 5ml increase in FEV(1) per mm CRL, p = 0.001, n = 283), forced vital capacity (FVC; 6 ml increase in FVC per mm CRL, p 0.001) and forced expiratory flow between 25% and 75% of FVC (FEF(25-75); 0.008 ml/s increase in FEF(25-75) per mm CRL, p = 0.023), and inverse relationships with CRL and current wheeze (OR 0.59 per CRL quartile, p = 0.026, n = 547) and asthma (OR 0.55 per CRL quartile p = 0.011). CRL was positively associated with maternal plasma alpha-tocopherol (p = 0.002).
Conclusions These findings support the concept of very early fetal programming of respiratory disease. Maternal vitamin E status may be one determinant for growth of the fetus and fetal lungs during early pregnancy.

• 出版日期2010-5