Increased risk of asthma in overweight children born large for gestational age

<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Being born large for gestational age (<jats:styled-content style="fixed-case">LGA</jats:styled-content>) is a marker of increased growth velocity in fetal life and a risk factor for childhood overweight. Both being born <jats:styled-content style="fixed-case">LGA</jats:styled-content> and childhood overweight may influence the development of asthma, although the role of overweight in the association between <jats:styled-content style="fixed-case">LGA</jats:styled-content> and childhood asthma is unclear. Importantly, recent studies have suggested that the association between overweight and asthma may be related to non‐allergic pathways. If this also applies to the association between <jats:styled-content style="fixed-case">LGA</jats:styled-content> and asthma, the association between being born <jats:styled-content style="fixed-case">LGA</jats:styled-content> and asthma may be different for atopic and non‐atopic children.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>We investigated the association of being <jats:styled-content style="fixed-case">LGA</jats:styled-content> with the prevalence of asthma at age 8 in atopic and non‐atopic children and the role of overweight in this association.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Complete data on asthma, anthropometry and atopy at age of 8 years, and potential confounders were available for 1608 participants of the <jats:styled-content style="fixed-case">PIAMA</jats:styled-content> birth cohort. Odds ratios for the association between <jats:styled-content style="fixed-case">LGA</jats:styled-content> and asthma in atopic and non‐atopic children were estimated by logistic regression analysis adjusting for potential confounders. Overweight was assessed as a potential modifier of the association between <jats:styled-content style="fixed-case">LGA</jats:styled-content> and asthma.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Being born <jats:styled-content style="fixed-case">LGA</jats:styled-content> was not significantly associated with asthma at age of 8 in atopic and non‐atopic children. However, overweight at age of 8 years modified the association between asthma at age of 8 and <jats:styled-content style="fixed-case">LGA</jats:styled-content>. In non‐atopic children, children who were born <jats:styled-content style="fixed-case">LGA</jats:styled-content> and were overweight at age of 8 years had a significantly increased odds of asthma compared to non‐<jats:styled-content style="fixed-case">LGA</jats:styled-content>, non‐overweight children (adj <jats:styled-content style="fixed-case">OR</jats:styled-content> 7.04; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 2.2‐24).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We observed that non‐atopic children born <jats:styled-content style="fixed-case">LGA</jats:styled-content>, who were overweight by 8 years have an increased risk of asthma. If confirmed, these findings suggest that non‐atopic children born <jats:styled-content style="fixed-case">LGA</jats:styled-content> may be identified early in life as a high‐risk group for asthma.</jats:p></jats:sec>