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Associations between fetal size, maternal α-tocopherol and childhood asthma
  1. Stephen W Turner1,
  2. Doris Campbell2,
  3. Norman Smith2,
  4. Leone C A Craig3,
  5. Geraldine McNeill3,
  6. Sarah H Forbes1,
  7. Paul J Harbour1,
  8. Anthony Seaton3,
  9. Peter J Helms1,
  10. Graham S Devereux3
  1. 1Department of Child Health, University of Aberdeen, Aberdeen, UK
  2. 2Department of Obstetrics and Gynaecology, University of Aberdeen, Aberdeen, UK
  3. 3Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, UK
  1. Correspondence to Dr Stephen W Turner, Department of Child Health, University of Aberdeen, Royal Aberdeen Children's Hospital, Foresterhill, Aberdeen AB25 2ZG, UK; s.w.turner{at}


Background The origins of respiratory disease might be traced back to exposures during fetal life. The aim of the present study was to explore whether there was a relationship between fetal size and respiratory outcomes at 5 years of age in the context of fetal exposure to vitamin E.

Methods A longitudinal birth cohort study was recruited (n=1924). Antenatal ultrasound scan results were identified and the following recorded: crown–rump length (CRL) in the first trimester; femur length (FL) and biparietal diameter (BPD) in the second trimester. Maternal plasma α-tocopherol (vitamin E) was measured at the time of the first trimester scan. At 5 years, wheeze and asthma symptoms were reported by questionnaire, and spirometry was measured.

Results CRL, spirometry and questionnaire data at 5 years were available for 835, 579 and 1145 individuals, respectively. There were positive associations between CRL and forced expiratory volume in 1 s (FEV1; 5 ml increase in FEV1 per mm CRL, p=0.001, n=283), forced vital capacity (FVC; 6 ml increase in FVC per mm CRL, p=0.001) and forced expiratory flow between 25% and 75% of FVC (FEF25–75; 0.008 ml/s increase in FEF25–75 per mm CRL, p=0.023), and inverse relationships with CRL and current wheeze (OR 0.59 per CRL quartile, p=0.026, n=547) and asthma (OR 0.55 per CRL quartile p=0.011). CRL was positively associated with maternal plasma α-tocopherol (p=0.002).

Conclusions These findings support the concept of very early fetal programming of respiratory disease. Maternal vitamin E status may be one determinant for growth of the fetus and fetal lungs during early pregnancy.

  • Asthma mechanisms
  • paediatric asthma

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  • Funding This study was funded by grants from Asthma UK and Tenovus Scotland neither of whom contributed to the study design, data analysis or preparation of this manuscript. The researchers are independent of Asthma UK and Tenovus Scotland.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the North of Scotland Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.