Mechanisms of asthma and allergic inflammation
Umbilical cord and maternal blood red cell fatty acids and early childhood wheezing and eczema

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Abstract

Background

Few studies have explored whether fetal exposure to n-6 and n-3 fatty acids influences the inception of atopic disease.

Objective

To assess prenatal fatty acid exposures as predictors of early childhood wheezing and eczema.

Methods

In the Avon Longitudinal Study of Parents and Children, late pregnancy maternal blood samples and umbilical cord blood samples were assayed for n-6 and n-3 fatty acids (percentage of total red cell phospholipid), and mothers were asked about wheezing and eczema in their children. We measured associations of 11 n-6 and n-3 fatty acid exposures with wheezing at 30 to 42 months, with wheezing patterns defined by presence (+) or absence (−) of wheezing during 2 periods, 0 to 6 months and 30 to 42 months (transient infant, +/−; later-onset, −/+; persistent, +/+; n = 1191 and n = 2764 for cord and maternal analyses, respectively), and with eczema at 18 to 30 months (n = 1238 and n = 2945 for cord and maternal analyses, respectively).

Results

In cord blood red cells, the ratio of arachidonic:eicosapentaenoic acid was positively associated with eczema (adjusted odds ratio [OR] per doubling, 1.14; 95% CI, 1.00-1.31; P = .044), the ratio of linoleic acid:α-linolenic acid was positively associated with later-onset wheeze (OR, 1.30; CI, 1.04-1.61; P = .019), and the ratio of α-linolenic acid:n-3 products was negatively associated with later-onset wheeze (OR, 0.86; CI, 0.75-0.99; P = .040). However, these associations were no longer significant after adjusting for multiple comparisons.

Conclusions

It seems unlikely that fetal exposure to n-6 and n-3 fatty acids is an important determinant of early childhood wheezing and atopic disease.

Section snippets

Methods

The Avon Longitudinal Study of Parents and Children (ALSPAC)8., 9. is a prospective study of 14,541 pregnancies that resulted in 14,062 live births (born to 13,866 mothers), of whom 13,988 survived to 1 year. Women were enrolled as early in pregnancy as possible on the basis of an expected date of delivery between April 1, 1991, and December 31, 1992, and place of residence within the 3 Bristol-based health districts of the former county of Avon, United Kingdom. It was estimated that 85% to 90%

Results

We examined the distribution of selected maternal and birth characteristics of children with and without cord and maternal blood fatty acid data (see Table EI in the Online Repository). Children with cord blood fatty acid data were born between January 1991 and January 1992, and children without data were born between February 1991 and February 1993. The ranges of birth dates for children with and without maternal blood fatty acid data were more similar. The main difference between children

Discussion

In this population-based follow-up study, we have not found convincing evidence that higher exposure to n-6 versus n-3 fatty acids in utero promotes the development of eczema or wheezing in early childhood, although the cord blood findings for the AA:EPA ratio and eczema and for the LA:ALA ratio and later-onset wheeze were in keeping with this hypothesis.

Conclusion

It seems unlikely that prenatal n-6:n-3 fatty acid exposure is an important determinant of wheezing and atopic disease in early childhood; however, further exploration of our cord findings in other studies would be of interest. In future analyses, we will examine relations of maternal and cord fatty acid exposures with atopic outcomes at school age and will also explore the role of maternal diet. Furthermore, the possible role of postnatal fatty acid intake in the inception, persistence, and

Acknowledgements

We thank all of the parents and children who provided data for this study and the midwives for their cooperation and help in recruitment. The whole ALSPAC study team is composed of interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers, and managers who continue to make the study possible. The ALSPAC study is part of the World Health Organization-initiated European Longitudinal Study of Pregnancy and Childhood. We thank the laboratory staff

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    Supported by the United Kingdom Medical Research Council. Dr Shaheen and Dr Newson were funded by the United Kingdom Department of Health. Core funding for the long-term follow-up of the ALSPAC cohort came from the United Kingdom Medical Research Council, the Wellcome Trust, the United Kingdom Department of Health, the Department of the Environment, the Department for Education and Employment, the National Institutes of Health, and a variety of medical research charities and other sponsors.

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