First trimester fetal size and prescribed asthma medication at 15 years of age

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Abstract

There is increasing evidence that antenatal factors predispose to childhood asthma. We tested the hypothesis that reduced first trimester fetal size is associated with increased risk for asthma at 15 years of age.

Fetal size in the first and second trimester was ascertained by ultrasound scan. The primary outcome of being dispensed one or more asthma medications by the family doctor in the year before the 15th birthday was determined from routinely acquired dispensing data.

Dispensing data were available for 1699 (88% of the original cohort) participants at 15 years of age and questionnaire data for 750 (39%). Each reduction in z-score for first trimester size was associated with increased odds for dispensed asthma medication at 15 years of age (OR 1.26, 95% CI 1.03–1.54) and self-reported use of asthma medications (OR 1.55, 95% CI 1.16–2.08). Overall, first and second trimester size and forced expiratory volume in 1 s at ages 5, 10 and 15 years were reduced for those dispensed asthma medications compared with those not dispensed asthma medications (p=0.003).

Antenatal factors that are active by the first trimester may contribute to respiratory well-being throughout childhood. Dropout from a birth cohort study can overestimate of the magnitude of any true association.
Original languageEnglish
Article number1701509
JournalEuropean Respiratory Journal
Volume51
Issue number2
Early online date31 Jan 2018
DOIs
Publication statusPublished - 2018

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First Pregnancy Trimester
Asthma
Second Pregnancy Trimester
Forced Expiratory Volume
Cohort Studies
Parturition

Keywords

  • asthma
  • epidemiology
  • child
  • fetus
  • longitudinal Studies

Cite this

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title = "First trimester fetal size and prescribed asthma medication at 15 years of age",
abstract = "There is increasing evidence that antenatal factors predispose to childhood asthma. We tested the hypothesis that reduced first trimester fetal size is associated with increased risk for asthma at 15 years of age.Fetal size in the first and second trimester was ascertained by ultrasound scan. The primary outcome of being dispensed one or more asthma medications by the family doctor in the year before the 15th birthday was determined from routinely acquired dispensing data.Dispensing data were available for 1699 (88{\%} of the original cohort) participants at 15 years of age and questionnaire data for 750 (39{\%}). Each reduction in z-score for first trimester size was associated with increased odds for dispensed asthma medication at 15 years of age (OR 1.26, 95{\%} CI 1.03–1.54) and self-reported use of asthma medications (OR 1.55, 95{\%} CI 1.16–2.08). Overall, first and second trimester size and forced expiratory volume in 1 s at ages 5, 10 and 15 years were reduced for those dispensed asthma medications compared with those not dispensed asthma medications (p=0.003).Antenatal factors that are active by the first trimester may contribute to respiratory well-being throughout childhood. Dropout from a birth cohort study can overestimate of the magnitude of any true association.",
keywords = "asthma, epidemiology, child, fetus, longitudinal Studies",
author = "Steve Turner and Shona Fielding and Graham Devereux",
note = "The authors would like to thank the participants and their parents for the enthusiasm for the study over the last 15 years. We would also like to thank Lindsay Vallance for her hard work in collecting the data for the 15 year follow up. We would also like to thank Dave Bailey of the eDRIS team in Edinburgh who provided the prescription data and also the Safe Haven team in Aberdeen who housed the linked dataset. Finally we would like to acknowledge the contribution of all the previous members of the SEATON team, and in particular Anthony Seaton who started it all off.",
year = "2018",
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AU - Turner, Steve

AU - Fielding, Shona

AU - Devereux, Graham

N1 - The authors would like to thank the participants and their parents for the enthusiasm for the study over the last 15 years. We would also like to thank Lindsay Vallance for her hard work in collecting the data for the 15 year follow up. We would also like to thank Dave Bailey of the eDRIS team in Edinburgh who provided the prescription data and also the Safe Haven team in Aberdeen who housed the linked dataset. Finally we would like to acknowledge the contribution of all the previous members of the SEATON team, and in particular Anthony Seaton who started it all off.

PY - 2018

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N2 - There is increasing evidence that antenatal factors predispose to childhood asthma. We tested the hypothesis that reduced first trimester fetal size is associated with increased risk for asthma at 15 years of age.Fetal size in the first and second trimester was ascertained by ultrasound scan. The primary outcome of being dispensed one or more asthma medications by the family doctor in the year before the 15th birthday was determined from routinely acquired dispensing data.Dispensing data were available for 1699 (88% of the original cohort) participants at 15 years of age and questionnaire data for 750 (39%). Each reduction in z-score for first trimester size was associated with increased odds for dispensed asthma medication at 15 years of age (OR 1.26, 95% CI 1.03–1.54) and self-reported use of asthma medications (OR 1.55, 95% CI 1.16–2.08). Overall, first and second trimester size and forced expiratory volume in 1 s at ages 5, 10 and 15 years were reduced for those dispensed asthma medications compared with those not dispensed asthma medications (p=0.003).Antenatal factors that are active by the first trimester may contribute to respiratory well-being throughout childhood. Dropout from a birth cohort study can overestimate of the magnitude of any true association.

AB - There is increasing evidence that antenatal factors predispose to childhood asthma. We tested the hypothesis that reduced first trimester fetal size is associated with increased risk for asthma at 15 years of age.Fetal size in the first and second trimester was ascertained by ultrasound scan. The primary outcome of being dispensed one or more asthma medications by the family doctor in the year before the 15th birthday was determined from routinely acquired dispensing data.Dispensing data were available for 1699 (88% of the original cohort) participants at 15 years of age and questionnaire data for 750 (39%). Each reduction in z-score for first trimester size was associated with increased odds for dispensed asthma medication at 15 years of age (OR 1.26, 95% CI 1.03–1.54) and self-reported use of asthma medications (OR 1.55, 95% CI 1.16–2.08). Overall, first and second trimester size and forced expiratory volume in 1 s at ages 5, 10 and 15 years were reduced for those dispensed asthma medications compared with those not dispensed asthma medications (p=0.003).Antenatal factors that are active by the first trimester may contribute to respiratory well-being throughout childhood. Dropout from a birth cohort study can overestimate of the magnitude of any true association.

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