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Thorax. Jan 2000; 55(1): 25–31.
PMCID: PMC1745589

Perinatal risk factors for asthma in Finnish adolescent twins


BACKGROUND—Previous studies have suggested that, in addition to genetic liability and environment in early childhood, intrauterine life also influences the risk for asthma beyond childhood. Low birth weight, prematurity, young maternal age, and maternal smoking have all shown an association with asthma. The effect of perinatal factors on the risk for asthma in relation to familial and social risk factors was studied in a nationwide population-based sample of adolescent twins. In addition to a distribution of birth characteristics among twins which differs from that of singletons, data on twins enable a distinction to be made between genetic and environmental sources of variation.
METHODS—Questionnaires were sent to five consecutive birth cohorts of Finnish 16 year old twins born in 1975-9 and to their parents (3065 families). The outcome measure was life time prevalence of doctor-diagnosed asthma in these adolescents. The association between asthma and potential risk factors was assessed by multiple logistic regression and discordant twin pair analysis.
RESULTS—Risk for asthma increased with increasing ponderal index (p for trend <0.01) and decreasing maternal age (p for trend <0.05). Among the 25% of twins with the highest ponderal index, the odds ratio for asthma was 1.82 (95% confidence interval 1.18 to 2.79) compared with those in the lowest 25%. Neither birth weight, gestational age, nor Apgar score was associated with asthma. When perinatal risk factors were combined with familial and social risk factors, ponderal index, maternal smoking, parental asthma, and sibship size were all significant independent determinants of asthma in these adolescents.
CONCLUSIONS—The risk for asthma in adolescent twins increases with increasing ponderal index when adjusted for familial and social factors.

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Selected References

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  • Barker DJ, Godfrey KM, Fall C, Osmond C, Winter PD, Shaheen SO. Relation of birth weight and childhood respiratory infection to adult lung function and death from chronic obstructive airways disease. BMJ. 1991 Sep 21;303(6804):671–675. [PMC free article] [PubMed]
  • Fergusson DM, Crane J, Beasley R, Horwood LJ. Perinatal factors and atopic disease in childhood. Clin Exp Allergy. 1997 Dec;27(12):1394–1401. [PubMed]
  • Rona RJ, Gulliford MC, Chinn S. Effects of prematurity and intrauterine growth on respiratory health and lung function in childhood. BMJ. 1993 Mar 27;306(6881):817–820. [PMC free article] [PubMed]
  • Seidman DS, Laor A, Gale R, Stevenson DK, Danon YL. Is low birth weight a risk factor for asthma during adolescence? Arch Dis Child. 1991 May;66(5):584–587. [PMC free article] [PubMed]
  • Bråbäck L, Hedberg A. Perinatal risk factors for atopic disease in conscripts. Clin Exp Allergy. 1998 Aug;28(8):936–942. [PubMed]
  • Shaheen SO, Sterne JA, Montgomery SM, Azima H. Birth weight, body mass index and asthma in young adults. Thorax. 1999 May;54(5):396–402. [PMC free article] [PubMed]
  • Lewis S, Richards D, Bynner J, Butler N, Britton J. Prospective study of risk factors for early and persistent wheezing in childhood. Eur Respir J. 1995 Mar;8(3):349–356. [PubMed]
  • von Mutius E, Nicolai T, Martinez FD. Prematurity as a risk factor for asthma in preadolescent children. J Pediatr. 1993 Aug;123(2):223–229. [PubMed]
  • Frischer T, Kuehr J, Meinert R, Karmaus W, Urbanek R. Risk factors for childhood asthma and recurrent wheezy bronchitis. Eur J Pediatr. 1993 Sep;152(9):771–775. [PubMed]
  • Strachan DP, Butland BK, Anderson HR. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ. 1996 May 11;312(7040):1195–1199. [PMC free article] [PubMed]
  • Strachan DP, Taylor EM, Carpenter RG. Family structure, neonatal infection, and hay fever in adolescence. Arch Dis Child. 1996 May;74(5):422–426. [PMC free article] [PubMed]
  • Olesen AB, Ellingsen AR, Olesen H, Juul S, Thestrup-Pedersen K. Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ. 1997 Apr 5;314(7086):1003–1008. [PMC free article] [PubMed]
  • Godfrey KM, Barker DJ, Osmond C. Disproportionate fetal growth and raised IgE concentration in adult life. Clin Exp Allergy. 1994 Jul;24(7):641–648. [PubMed]
  • Martin N, Boomsma D, Machin G. A twin-pronged attack on complex traits. Nat Genet. 1997 Dec;17(4):387–392. [PubMed]
  • Laitinen T, Räsänen M, Kaprio J, Koskenvuo M, Laitinen LA. Importance of genetic factors in adolescent asthma: a population-based twin-family study. Am J Respir Crit Care Med. 1998 Apr;157(4 Pt 1):1073–1078. [PubMed]
  • Aarnio M, Kujala UM, Kaprio J. Associations of health-related behaviors, school type and health status to physical activity patterns in 16 year old boys and girls. Scand J Soc Med. 1997 Sep;25(3):156–167. [PubMed]
  • Vesterinen E, Kaprio J, Koskenvuo M. Prospective study of asthma in relation to smoking habits among 14,729 adults. Thorax. 1988 Jul;43(7):534–539. [PMC free article] [PubMed]
  • Aarnio M, Winter T, Kujala UM, Kaprio J. Familial aggregation of leisure-time physical activity -- a three generation study. Int J Sports Med. 1997 Oct;18(7):549–556. [PubMed]
  • Seidman DS, Slater PE, Ever-Hadani P, Gale R. Accuracy of mothers' recall of birthweight and gestational age. Br J Obstet Gynaecol. 1987 Aug;94(8):731–735. [PubMed]
  • Cole TJ, Henson GL, Tremble JM, Colley NV. Birthweight for length: ponderal index, body mass index or Benn index? Ann Hum Biol. 1997 Jul-Aug;24(4):289–298. [PubMed]
  • Duffy DL, Mitchell CA, Martin NG. Genetic and environmental risk factors for asthma: a cotwin-control study. Am J Respir Crit Care Med. 1998 Mar;157(3 Pt 1):840–845. [PubMed]
  • Rimpelä AH, Savonius B, Rimpelä MK, Haahtela T. Asthma and allergic rhinitis among Finnish adolescents in 1977-1991. Scand J Soc Med. 1995 Mar;23(1):60–65. [PubMed]
  • Räsänen M, Laitinen T, Kaprio J, Koskenvuo M, Laitinen LA. Hay fever--a Finnish nationwide study of adolescent twins and their parents. Allergy. 1998 Sep;53(9):885–890. [PubMed]
  • Remes ST, Korppi M, Remes K, Pekkanen J. Prevalence of asthma at school age: a clinical population-based study in eastern Finland. Acta Paediatr. 1996 Jan;85(1):59–63. [PubMed]
  • Svanes C, Omenaas E, Heuch JM, Irgens LM, Gulsvik A. Birth characteristics and asthma symptoms in young adults: results from a population-based cohort study in Norway. Eur Respir J. 1998 Dec;12(6):1366–1370. [PubMed]
  • Wilson RS. Twin growth: initial deficit, recovery, and trends in concordance from birth to nine years. Ann Hum Biol. 1979 May-Jun;6(3):205–220. [PubMed]
  • Rasmussen F, Johansson M. The relation of weight, length and ponderal index at birth to body mass index and overweight among 18-year-old males in Sweden. Eur J Epidemiol. 1998 Jun;14(4):373–380. [PubMed]
  • Luder E, Melnik TA, DiMaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr. 1998 Apr;132(4):699–703. [PubMed]
  • Cook DG, Strachan DP. Health effects of passive smoking. 3. Parental smoking and prevalence of respiratory symptoms and asthma in school age children. Thorax. 1997 Dec;52(12):1081–1094. [PMC free article] [PubMed]
  • Cliver SP, Goldenberg RL, Cutter GR, Hoffman HJ, Davis RO, Nelson KG. The effect of cigarette smoking on neonatal anthropometric measurements. Obstet Gynecol. 1995 Apr;85(4):625–630. [PubMed]

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