Pregnancy and perinatal conditions and atopic disease prevalence in childhood and adulthood

Abstract

Background

Previous studies showed controversial results for the influence of pregnancy-related and perinatal factors on subsequent respiratory and atopic diseases in children. The aim of this study was to assess the association between perinatal variables and the prevalence of asthma, bronchial hyperreactivity, flexural eczema, allergic rhinitis, and sensitization in childhood and early adulthood.

Methods

The studied population was first examined in Munich and Dresden in 1995/1996 at age 9-11 yrs. Participants were followed until age 19-24 yrs. using questionnaires and clinical examinations. Associations between perinatal data and subsequent atopic diseases were examined using logistic regression analyses adjusting for potential confounders.

Results

Cesarean section was statistically significantly associated with BHR in early adulthood (Odds Ratio 4.8, 95% confidence interval 1.5-15.2), while assisted birth was associated with presence of asthma symptoms in childhood (2.2, 1.2-3.9), flexural eczema symptoms (2.2, 1.2-4.3) and doctor's diagnosis of atopic dermatitis (1.9, 1.0-3.4) in childhood, and sensitization in early adulthood (2.2, 1.1-4.3). Lower birth length (1.9, 1.1-3.2), lower birth weight (0.5, 0.3-0.9) and higher birth weight (0.6 (0.4-1.0)) were predictive of sensitization in early adulthood compared to average birth length and birth weight, respectively. None of the other perinatal factors showed statistically significant associations with the outcomes.

Conclusions

Our results indicate that children, who are born by Cesarean section and especially by assisted birth, might be at greater risk for developing asthma, flexural eczema and sensitization and should hence be monitored. Prenatal maternal stress might partly explain these associations, which should be further investigated.

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