Perinatal risk factors for asthma in Finnish adolescent twins
Maija Räsänena, Jaakko Kapriob c, Tarja Laitinend, Torsten Winterb, Markku Koskenvuoe, Lauri A Laitinenf
a Helsinki University
Central Hospital, Department of Medicine, Division of Pulmonary
Medicine, P O Box 340, FIN-00029 HUCH, Finland, b Department of Public Health, University of
Helsinki, c Department of Mental Health and Alcohol
Research, National Public Health Institute, d Haartman
Institute, Department of Medical Genetics, University of Helsinki, e Department of Public Health,
University of Turku, f Helsinki
University Central Hospital, Department of Medicine
Correspondence to: Dr M Räsänen
Received 15 March 1999; Returned to authors 12 May 1999; Revised version received 30 September 1999; Accepted for publication 30 September 1999
BACKGROUND
Previous
studies have suggested that, in addition to genetic liability and
environment in early childhood, intrauterine life also influences
the risk for asthma beyond childhood. Low birth weight, prematurity,
young maternal age, and maternal smoking have all shown an association
with asthma. The effect of perinatal factors on the risk for asthma in
relation to familial and social risk factors was studied in a
nationwide population-based sample of adolescent twins. In addition to
a distribution of birth characteristics among twins which differs from
that of singletons, data on twins enable a distinction to be made
between genetic and environmental sources of variation.
METHODSQuestionnaires
were sent to five consecutive birth cohorts of Finnish 16 year old
twins born in 1975-9 and to their parents (3065 families). The outcome
measure was life time prevalence of doctor-diagnosed asthma in these
adolescents. The association between asthma and potential risk factors
was assessed by multiple logistic regression and discordant twin pair analysis.
RESULTSRisk for
asthma increased with increasing ponderal index (p for trend <0.01)
and decreasing maternal age (p for trend <0.05). Among the 25% of
twins with the highest ponderal index, the odds ratio for asthma was
1.82 (95% confidence interval 1.18 to 2.79) compared with those in the
lowest 25%. Neither birth weight, gestational age, nor Apgar score was
associated with asthma. When perinatal risk factors were combined with
familial and social risk factors, ponderal index, maternal smoking,
parental asthma, and sibship size were all significant independent
determinants of asthma in these adolescents.
CONCLUSIONSThe risk
for asthma in adolescent twins increases with increasing ponderal index
when adjusted for familial and social factors.
Keywords: asthma; perinatal factors; twins
© 2000 by Thorax
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