Intrauterine bacterial growth at birth and risk of asthma and allergic sensitization among offspring at the age of 15 to 17 years
Received 5 July 2008; received in revised form 11 March 2009; accepted 12 March 2009. published online 08 May 2009.
Background
Microbial colonization of the airways and intestine during birth might have an effect on the risk of asthma and allergic diseases later in life.
Objective
We sought to evaluate the association between intrauterine microbial growth at the time of delivery and the development of asthma and allergic sensitization among offspring.
Methods
Intrauterine bacterial culture results were recorded at the time of cesarean delivery of 460 children who were born at Kuopio University Hospital during 1990–1992. When the children reached the age of 15 to 17 years, self-administered questionnaires were sent to the mothers, and 382 of the children were also examined by using skin prick tests.
Results
Intrauterine growth of potential pathogenic anaerobic bacteria and Streptococcus species at birth was associated with an increased risk of doctor-diagnosed asthma ever (odds ratio [OR], 4.51 [95% CI, 1.56–13.0]; OR, 2.53 [95% CI, 1.19–5.38]) and doctor-diagnosed current asthma (OR, 7.34 [95% CI, 2.44–22.03]; OR, 3.37 [95% CI, 1.46–7.76]) at the age of 15 to 17 years compared with the risk seen in subjects with negative microbial cultures. These findings remained significant also after applying the Bonferroni correction. No significant association after the Bonferroni correction was detected between intrauterine microbial growth and allergic sensitization among offspring.
Conclusion
The results of this study indicated that specific intrauterine microbial growth at the time of birth might increase the risk of asthma among offspring through inflammatory mechanisms. These results indicate new potential targets for future studies on the effects of maternal vaginal microflora and intrauterine infection in the development of asthma among children
aEnvironmental Health Department, National Institute for Health and Welfare, Kuopio, Finland
bDepartment of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
cDepartment of Clinical Microbiology, Kuopio University Hospital, Kuopio, Finland
dDepartment of Pediatrics, Kuopio University Hospital, Kuopio, Finland
eSchool of Public Health and Clinical Nutrition, University of Kuopio, Kuopio, Finland
Reprint requests: Leea Keski-Nisula, MD, PhD, Department of Obstetrics and Gynecology, Kuopio University Hospital, PL 1777, 70211 Kuopio, Finland.
Supported by the Finnish Medical Association, the Jalmari and Rauha Ahokas Foundation, the Kerttu and Kalle Viik Foundation, and the National Public Health Institute.
Disclosure of potential conflict of interest: L. Keski-Nisula received personal scholarships from the Finnish Medical Association, the Jalmari and Rauha Ahokas Foundation, and the Kerttu and Kalle Viik Foundation. J. Pekkanen received grant support from the European Union 7th Framework Programme, Finnish Foundation, and the Academy of Finland. The rest if the authors have declared that they have no conflict of interest.
ABSTRACT