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

Steve Turner; Shona  Fielding; Graham Devereux

doi:10.1183/13993003.01509-2017

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

Steve Turner^* (Corresponding Author), Shona Fielding, Graham Devereux

^*Corresponding author for this work

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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 language	English
Article number	1701509
Number of pages	9
Journal	European Respiratory Journal
Volume	51
Issue number	2
Early online date	31 Jan 2018
DOIs	https://doi.org/10.1183/13993003.01509-2017
Publication status	Published - 1 Feb 2018

Keywords

asthma
epidemiology
child
fetus
longitudinal Studies

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10.1183/13993003.01509-2017Licence: Unspecified

Accepted Manuscript
This is an author-submitted, peer-reviewed version of a manuscript that has been accepted for publication in the European Respiratory Journal, prior to copy-editing, formatting and typesetting. This version of the manuscript may not be duplicated or reproduced without prior permission from the copyright owner, the European Respiratory Society. The publisher is not responsible or liable for any errors or omissions in this version of the manuscript or in any version derived from it by any other parties. The final, copy-edited, published article, which is the version of record, is available without a subscription 18 months after the date of issue publication.
Accepted author manuscript, 927 KBLicence: Other

Graham Devereux
- School of Medicine, Medical Sciences & Nutrition, Applied Health Sciences - Personal Chair (Clinical)
- Institute of Applied Health Sciences
Person: Clinical Academic
Stephen Turner
- FLAMINGO Study
- School of Medicine, Medical Sciences & Nutrition, Applied Health Sciences - Honorary Professor
Person: Honorary

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 = "Support statement This study was funded by Research Councils UK, Medical Research Council. Funding information for this article has been deposited with the Crossref Funder Registry. Acknowledgements 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. ",

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N1 - Support statement This study was funded by Research Councils UK, Medical Research Council. Funding information for this article has been deposited with the Crossref Funder Registry. Acknowledgements 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.

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

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Graham Devereux

Stephen Turner

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