Date of Award


Document Type

Open Access Thesis


Epidemiology and Biostatistics


The Norman J. Arnold School of Public Health

First Advisor

Jihong Liu


Introduction: Obesity is common among women of childbearing age and intrauterine exposures may influence the development of early childhood asthma. A handful of studies have investigated pre-pregnancy obesity, but even fewer have thoroughly explored gestational weight gain as possible childhood asthma risk factors. Gaps remain in the literature and to our knowledge, none have longitudinally explored these relationships in a nationally representative sample of U.S. children.

Methods: We used data from the Early Childhood Longitudinal Study – Birth Cohort, in which children were followed through age four (n≈5,200). Asthma was based on parent report of a physician’s diagnosis. Four definitions of gestational weight gain were used. Generalized estimating equation binomial models were used to compute adjusted odds ratios (aOR) and 95% confidence intervals.

Results: Compared to children of normal weight mothers, children born to obese mothers had an overall increased risk of early childhood asthma (aOR: 1.63 95% CI: 1.25-2.11); whereas pre-pregnancy overweight fell just below statistical significance (aOR: 1.26 95% CI 0.99-1.60). Extreme weight gains (<5kg and ≥25kg) were also independently associated with increased risks of asthma; however, no other significant associations were observed for weight gain and offspring’s asthma.

Conclusions: We found that in the U.S., extreme weight gain levels, maternal obesity, and to a lesser extent maternal overweight are risk factors of early childhood asthma. Exceeding weight gain recommendations was not a risk factor for asthma. Our study provides further evidence for the long-term effects intrauterine exposures may have on children and the need to target preconception care in improving child health indicators.

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