The association of prenatal C-reactive protein levels with childhood asthma and atopy

Objective

To describe the association of systemic prenatal inflammation, measured by plasma C-reactive protein (CRP), with childhood asthma, eczema, and allergic rhinitis.

Methods

522 maternal-offspring pairs from the Vitamin D Antenatal Asthma Reduction Trial (VDAART) were included. Prenatal plasma CRP was measured between 10-18 weeks gestation and between 32-38 weeks gestation. Offspring asthma, eczema, and allergic rhinitis were assessed quarterly between birth and age 6 years. We performed mediation analyses of prenatal CRP on the association between several maternal characteristics and offspring asthma.

Results

Elevated early and late prenatal CRP and an increase in CRP from early to late pregnancy were associated with asthma by age 6 years (early: adjusted odds ratio (aOR) 1.76, 95% CI 1.12,2.82, p=0.02; late: aOR 2.45, 95% CI 1.47, 4.18, p<0.001; CRP increase aOR 2.06, 95% CI 1.26, 3.39, p<0.004). Prenatal CRP and childhood asthma associations were strengthened among offspring with atopic asthma (early: aOR 3.78, 95% CI 1.49, 10.64, p=0.008; late: aOR 4.84, 95% CI 1.68, 15.50, p=0.005, CRP increase aOR 3.01, 95% CI 1.06, 9.16, p=0.04). Early and late prenatal CRP mediated 96% and 86% of the association between maternal pre-pregnancy body mass index and offspring asthma, respectively.

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