- Reduced fetal size during gestation affects the respiratory well-being of children aged 5 to 15
- Fetal sizes were determined using ultrasound during first and second trimesters of pregnancy.
- Asthma and lung function were assessed at 5, 10 and
15 years of age in children.
- Larger fetuses were at reduced risk for
asthma and had better lung function and persistent asthma and reduced lung
function was associated with smaller fetal sizes.
risk of asthma
and reduced lung function are seen
in children aged 5 years to 15 years who were small for gestational age as
study was conducted by Dr. Stephen Turner,
University of Aberdeen, UK and colleagues. The research presented at the European Respiratory Society (ERS) International Congress in London suggests that antenatal factors during pregnancy
contribute to the
life-long respiratory well-being of the child.
‘Increased fetal size is linked to reduced asthma risk and better lung function in children.’
In the previously conducted study, Turner and his
colleagues had linked reduced fetal size during the first trimester (T1)
risk of asthma up to ten years.
present research associates reduced fetal size with reduced
lung function and persistent asthma from ages 5 to 15 years.
the study, 2000 mothers from an antenatal clinic in Aberdeen were recruited,
between the years 1997 and 1999. The fetal size during
the first and second trimester was ascertained by routine
status and lung function were determined at ages 5, 10 and 15 years. Then various models and statistical techniques
were applied to the data.
results showed that larger fetuses were at reduced risk for
asthma and had better lung function. Fetal size was
expressed as a z-score, which is a statistical method of expressing difference
from normal; four z scores cover the range from abnormally small to abnormally
first trimester with increase in each z score, an overall reduction
of risk for asthma between ages 5, 10 and 15 (OR 0.78) by
22% was seen, a result which applied even after adjustment for
fetal size was also associated with increased lung function, again independent
of confounding factors. Persistent asthma was associated with small
fetal sizes at first and second trimesters and FEV1 at ages 5,
10 and 15 years.
Turner concludes "First trimester fetal size - a surrogate for fetal lung
size - is relevant to symptoms and respiratory physiology through to 15 years
of age. These findings suggest that antenatal factors contribute to life-long
respiratory well-being." He adds "What we
need to do now is first replicate these findings in other cohorts and then work
out whether it is fetuses which start off small and stay small who have the
worst outcomes or whether it is those that start off normal size (before 10
weeks) and then become small who are in trouble. Ultimately, any intervention
is going to boil down to mothers not smoking or drinking, having a balanced
diet and taking regular exercise - but this is good incentive for a healthy