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Master of Public Health

Prenatal polyunsaturated fatty acids and child asthma: effect modification by maternal asthma and child sex

AUTHORS

Rosa MJ , Hartman TJ , Adgent M , Gardner K , Gebretsadik T , Moore PE , Davis RL , LeWinn KZ , Bush NR , Tylavsky F , Wright RJ , Carroll KN , . The Journal of allergy and clinical immunology. 2019 12 3; ().

ABSTRACT

BACKGROUND: Findings on prenatal polyunsaturated fatty acid (PUFA) intake and child wheeze and asthma have been inconsistent.

OBJECTIVE: We examined associations between prenatal PUFA status and child wheeze/asthma and modifying effects of maternal asthma/atopy, child sex and maternal race.

METHODS: Analyses included 1019 mother-child dyads with n-3 and n-6 PUFAs measured in 2 trimester plasma; n-6/n-3 ratios were calculated. Child wheeze/asthma outcomes ascertained at age 4-6 years included: ever physician-diagnosed asthma, current wheeze (symptoms past 12 months), current asthma (diagnosis and medication and/or symptoms past 12 months) and current diagnosed asthma. Each PUFA indicator and outcome was analyzed in separate models using modified Poisson regression with interaction terms.

RESULTS: In quartile (Q) analyses, higher n-6 PUFAs were associated with increased risk of ever (relative risk high v. low [RR Q4 v.Q1]: 1.70; 95% CI: 1.07, 2.71) and current (RR Q4 v. Q1: 1.70; 95% CI: 1.07, 2.71) diagnosed asthma while n-3 PUFAs were associated with lower risk (RR Q4 v. Q1 0.59; 95% CI: 0.33, 1.03) of current diagnosed asthma (p<0.05 for all). Higher n-6 PUFAs were associated with higher risk of all respiratory outcomes among children born to women with asthma (p<0.05 for all outcomes). A significant three-way interaction between child sex, maternal asthma and n-6/n-3 PUFA -indicated that male children born to women with asthma and a higher ratio had the highest risk across wheeze/asthma outcomes (p<0.05).

CONCLUSION: Associations between prenatal PUFA status and childhood wheeze/asthma were modified by maternal history of asthma and child sex.

KEY MESSAGES: Maternal polyunsaturated fatty acids in pregnancy are predictors of asthma risk in childhood and these associations are potentially modified by maternal asthma and child sex.

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