Thorax 1999;54:396-402 ( May )

Birth weight, body mass index and asthma in young adults

Seif O Shaheen,^a Jonathan A C Sterne,^a Scott M Montgomery,^b Hossain Azima^a

^a Department of Public Health Sciences, Guy's, King's and St Thomas' School of Medicine, London SE1 3QD, UK, ^b Department of Medicine, Royal Free and University College Medical School, London NW3 2PF, UK

Correspondence to: Dr S Shaheen.

Received 27 July 1998; Returned to authors 16 September 1998; Revised version received 16 December 1998; Accepted for publication 16 December 1998

BACKGROUNDImpaired fetal growth may be a risk factor for asthma although evidence in children is conflicting and there are few data in adults. Little is known about risk factors which may influence asthma in late childhood or early adult life. Whilst there are clues that fatness may be important, this has been little studied in young adults. The relations between birth weight and childhood and adult anthropometry and asthma, wheeze, hayfever, and eczema were investigated in a nationally representative sample of young British adults.
METHODSA total of 8960 individuals from the 1970 British Cohort Study (BCS70) were studied. They had recently responded to a questionnaire at 26 years of age in which they were asked whether they had suffered from asthma, wheeze, hayfever, and eczema in the previous 12 months. Adult body mass index (BMI) was calculated from reported height and weight.
RESULTSThe prevalence of asthma at 26 years fell with increasing birth weight. After controlling for potential confounding factors, the odds ratio comparing the lowest birth weight group (<2 kg) with the modal group (3-3.5 kg) was 1.99 (95% CI 0.96 to 4.12). The prevalence of asthma increased with increasing adult BMI. After controlling for birth weight and other confounders, the odds ratio comparing highest with lowest quintile was 1.72 (95% CI 1.29 to 2.29). The association between fatness and asthma was stronger in women; odds ratios comparing overweight women (BMI 25-29.99) and obese women (BMI 30) with those of normal weight (BMI <25) were 1.51 (95% CI 1.11 to 2.06) and 1.84 (95% CI 1.19 to 2.84), respectively. The BMI at 10 years was not related to adult asthma. Similar associations with birth weight and adult BMI were present for wheeze but not for hayfever or eczema.
CONCLUSIONSImpaired fetal growth and adult fatness are risk factors for adult asthma.


Keywords: adult asthma; body mass index; birth weight

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© 1999 by Thorax
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