Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya

Meme, H. et al. (2023) Preterm birth, birth weight, infant weight gain and their associations with childhood asthma and spirometry: a cross-sectional observational study in Nairobi, Kenya. BMJ Open Respiratory Research, 10(1), e001895. (doi: 10.1136/bmjresp-2023-001895) (PMID:37735103) (PMCID:PMC10514609)

Abstract

Background: In sub-Saharan Africa, the origins of asthma and high prevalence of abnormal lung function remain unclear. In high-income countries (HICs), associations between birth measurements and childhood asthma and lung function highlight the importance of antenatal and early life factors in the aetiology of asthma and abnormal lung function in children. We present here the first study in sub-Saharan Africa to relate birth characteristics to both childhood respiratory symptoms and lung function. Methods: Children attending schools in two socioeconomically contrasting but geographically close areas of Nairobi, Kenya, were recruited to a cross-sectional study of childhood asthma and lung function. Questionnaires quantified respiratory symptoms and preterm birth; lung function was measured by spirometry; and parents were invited to bring the child’s immunisation booklet containing records of birth weight and serial weights in the first year. Results: 2373 children participated, 52% girls, median age (IQR), 10 years (8–13). Spirometry data were available for 1622. Child immunisation booklets were available for 500 and birth weight and infant weight gain data were available for 323 and 494 children, respectively. In multivariable analyses, preterm birth was associated with the childhood symptoms ‘wheeze in the last 12 months’; OR 1.64, (95% CI 1.03 to 2.62), p=0.038; and ‘trouble breathing’ 3.18 (95% CI 2.27 to 4.45), p<0.001. Birth weight (kg) was associated with forced expiratory volume in 1 s z-score, regression coefficient (β) 0.30 (0.08, 0.52), p=0.008, FVC z-score 0.29 (95% CI 0.08 to 0.51); p=0.008 and restricted spirometry, OR 0.11 (95% CI 0.02 to 0.78), p=0.027. Conclusion: These associations are in keeping with those in HICs and highlight antenatal factors in the aetiology of asthma and lung function abnormalities in sub-Saharan Africa.

• Item Type: Articles
• Additional Information: Funded by UKRI MRC/Kenya National Research Fund (NRF) UK-Kenya Joint Partnership on Non-Communicable Disease programme under the Newton fund MR/S009027/1 Sensitisation activities additionally funded by Wellcome Public Engagement Fund 218935/Z/19/Z.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gray, Professor Cindy
• Authors: Meme, H., Amukoye, E., Bowyer, C., Chakaya, J., Dobson, R., Fuld, J., Gray, C. M., Kiplimo, R., Lesosky, M., Mortimer, K., Ndombi, A., Obasi, A., Orina, F., Quint, J. K., Semple, S., West, S. E., Zurba, L., and Devereux, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing; College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
• Journal Name: BMJ Open Respiratory Research
• Publisher: BMJ Publishing Group
• ISSN: 2052-4439
• ISSN (Online): 2052-4439
• Published Online: 21 September 2023
• Copyright Holders: Copyright © Author(s) (or their employer(s)) 2023.
• First Published: First published in BMJ Open 10(1):e001895
• Publisher Policy: Reproduced under a Creative Commons license

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
308476		Clean air, good health : an arts-based, participatory approach to air pollution research in Nairobi, Kenya	Lucinda Gray	Wellcome Trust (WELLCOTR)	218935/Z/19/Z	S&PS - Institute of Health & Wellbeing (Social Sciences)