Maternal pre-pregnancy body mass index, gestational weight gain, and
risk of childhood asthma/wheeze: A systematic review and meta-analysis
of cohort studies
Abstract
Introduction: The goal of this study was to evaluate the association
between maternal pre-pregnancy body mass index (BMI), gestational weight
gain (GWG) and risk of childhood asthma/wheeze by conducting a
meta-analysis of cohort studies. Methods: A systematic literature search
of several databases was conducted through January 2020 to identify
relevant studies. The exposure of interest was maternal pre-pregnancy
BMI (e.g., underweight, overweight, obesity, and continuous BMI) and GWG
(e.g., inadequate GWG, excessive GWG, GWG < 9 kg, GWG
> 15 kg, and continuous GWG). Random-effects models were
used to calculate the pooled odds ratios (ORs) and their 95% confidence
intervals (CIs). Results: Twenty-one cohort studies were included (N =
150,198 mother-child pairs). Age of children was 3 months to 16 years.
Maternal overweight (OR = 1.13; 95% CI: 1.07 - 1.19) and obesity (OR =
1.39; 95% CI: 1.23 - 1.58) were associated with higher odds of
childhood asthma/wheeze; each 1-kg/m2 increase in maternal pre-pregnancy
BMI was associated with a 4% increase in the odds of childhood
asthma/wheeze. GWG < 9 kg (OR = 1.08; 95% CI, 1.01 - 1.14)
was slightly associated with higher odds of childhood asthma/wheeze.
Subgroup analyses have identified several variables associated with the
between-study heterogeneity. Conclusions: Maternal overweight and
obesity are associated with an elevated risk of childhood asthma/wheeze,
suggesting that maternal pre-pregnancy BMI need to be considered in
studies on the early origins of asthma. Further studies are needed to
confirm the association between GWG and risk of childhood asthma/wheeze.