Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood: A cross-sectional study

Kelvin Macdonald, Kimberly K. Vesco, Kristine L. Funk, Jerena Donovan, Thuan Nguyen, Zunqiu Chen, Jodi Lapidus, Victor J. Stevens, Cynthia (Cindy) McEvoy

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Rationale: Maternal prepregnancy obesity has been associated with early wheeze and childhood asthma in their offspring. Some of these studies have been in minority, urban, and disadvantaged populations using parental recall and questionnaires. The association of maternal prepregnancy obesity with bronchodilator dispensing to their offspring, in a primarily insured, non-urban, White population in the United States is unknown. Objectives and Methods: We conducted a retrospective cohort study using pharmacy dispensing data from the electronic medical records of a large United States health maintenance organization to examine the relationship between maternal prepregnancy body mass index (BMI) and inhaled bronchodilator dispensing in the offspring to 4 years of age. We included infants ≥37 weeks' gestation with birth weight ≥2.5 kg which yielded 6,194 mother-baby pairs. Maternal prepregnancy BMI was categorized as underweight (<18.5 kg/m2), normal (18.5−24.9 kg/m2), overweight (25−29.9 kg/m2), or obese (≥30 kg/m2). Results: In the entire cohort, 27.6% of the offspring received a bronchodilator dispensing. This ranged from 19.2% in the offspring of underweight mothers to 31.3% of those born to obese mothers. In the fully adjusted model using normal BMI as the referent, children of obese mothers had a 22% higher rate of bronchodilator dispensing (adjusted OR = 1.22; 95%CI 1.05–1.41; P = 0.008). Conclusions: In this insured, non-urban, White population, maternal prepregnancy obesity was associated with bronchodilator dispensing in the offspring in early life. These results extend previous data and reaffirm the potential widespread public health impact that prepregnancy obesity may have on subsequent childhood respiratory health. Pediatr Pulmonol. 2016;51:803–811.

Original languageEnglish (US)
Pages (from-to)803-811
Number of pages9
JournalPediatric Pulmonology
Volume51
Issue number8
DOIs
StatePublished - Aug 1 2016

Fingerprint

Bronchodilator Agents
Body Mass Index
Cross-Sectional Studies
Mothers
Pregnancy
Obesity
Thinness
Urban Population
Health Maintenance Organizations
Electronic Health Records
Vulnerable Populations
Birth Weight
Population
Cohort Studies
Asthma
Retrospective Studies
Public Health
Health

Keywords

  • bronchodilator
  • maternal obesity
  • pediatrics
  • wheeze

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Maternal body mass index before pregnancy is associated with increased bronchodilator dispensing in early childhood : A cross-sectional study. / Macdonald, Kelvin; Vesco, Kimberly K.; Funk, Kristine L.; Donovan, Jerena; Nguyen, Thuan; Chen, Zunqiu; Lapidus, Jodi; Stevens, Victor J.; McEvoy, Cynthia (Cindy).

In: Pediatric Pulmonology, Vol. 51, No. 8, 01.08.2016, p. 803-811.

Research output: Contribution to journalArticle

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abstract = "Rationale: Maternal prepregnancy obesity has been associated with early wheeze and childhood asthma in their offspring. Some of these studies have been in minority, urban, and disadvantaged populations using parental recall and questionnaires. The association of maternal prepregnancy obesity with bronchodilator dispensing to their offspring, in a primarily insured, non-urban, White population in the United States is unknown. Objectives and Methods: We conducted a retrospective cohort study using pharmacy dispensing data from the electronic medical records of a large United States health maintenance organization to examine the relationship between maternal prepregnancy body mass index (BMI) and inhaled bronchodilator dispensing in the offspring to 4 years of age. We included infants ≥37 weeks' gestation with birth weight ≥2.5 kg which yielded 6,194 mother-baby pairs. Maternal prepregnancy BMI was categorized as underweight (<18.5 kg/m2), normal (18.5−24.9 kg/m2), overweight (25−29.9 kg/m2), or obese (≥30 kg/m2). Results: In the entire cohort, 27.6{\%} of the offspring received a bronchodilator dispensing. This ranged from 19.2{\%} in the offspring of underweight mothers to 31.3{\%} of those born to obese mothers. In the fully adjusted model using normal BMI as the referent, children of obese mothers had a 22{\%} higher rate of bronchodilator dispensing (adjusted OR = 1.22; 95{\%}CI 1.05–1.41; P = 0.008). Conclusions: In this insured, non-urban, White population, maternal prepregnancy obesity was associated with bronchodilator dispensing in the offspring in early life. These results extend previous data and reaffirm the potential widespread public health impact that prepregnancy obesity may have on subsequent childhood respiratory health. Pediatr Pulmonol. 2016;51:803–811.",
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AU - Donovan, Jerena

AU - Nguyen, Thuan

AU - Chen, Zunqiu

AU - Lapidus, Jodi

AU - Stevens, Victor J.

AU - McEvoy, Cynthia (Cindy)

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