Gestational weight may lead to early childhood asthma in children. An Asthma pump and inhaler are suitable asthma treatments. Read more about asthma at Meri Sehat.

Is Your Asthma Due To Your Mother's Gestational Weight Gain?

Is Your Asthma Due To Your Mother’s Gestational Weight Gain?

Introduction

Gestational weight gain and high BMI (body mass index) affects a majority of pregnant women. There are various factors such as social factors, environmental factors, maternal factors, and energy balance that could contribute to weight gain <a href="https://merisehat.pk/disease/lets-talk-about-sex-during-pregnancy">during pregnancy</a>.&nbsp; 
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Although gestational weight gain (GWG) is a natural response to accommodate a growing fetus, GWG that is either too high or too low contributes to long-term or short-term health complications. This specifically applies for women whose BMI is greater than 25 at the time of their pregnancy. 
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The number of women who experience excessive gestational weight gain while they are pregnant is increasing, irrespective of their socio-economic status. Institute of Medicine, USA, has worked on identifying optimal gestational weight, so healthcare providers can advise pregnant women accordingly<a href="#accordion">[1]</a>.

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Understanding The Impact Of Pregnancy Weight Gain On Childhood Asthma

Extreme gestational weight gain has a significant impact on pregnant women and their health. It increases risk of birth complications, and leads to long-term maternal obesity. 
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Additionally, excessive gestational weight gain is harmful for the child, especially because of increased risk of childhood obesity<a href="#accordion">[2]</a>. There is also enough evidence to link maternal obesity with childhood obstructive lung diseases, e.g., asthma<a href="#accordion">[3]</a>. 
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<h5>GWG And Asthma&nbsp;</h5>

Obesity during pregnancy is directly related to adverse outcomes in children, e.g., higher probability of developing asthma&nbsp; 
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The mechanism to identify this connection is fetal programming. It describes the in-utero exposure that influences gene expression and chronic diseases during childhood. The disease originates from metabolic and psychological adaptations, which are made by the fetus in response to in-utero exposures during critically sensitive developmental phases. Moreover, environmental and genetic factors also play a role in the immune modulatory effects. 
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<h5>The Effects Of BMI</h5>

It&rsquo;s difficult to gauge the effects of the mother&rsquo;s and the child&rsquo;s BMI on childhood asthma. Researchers have investigated the mediating effects of BMI by adding childhood body mass index to their variable models with two or more quantities, and further describing what would reduce the risk. 
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Some studies concluded that birth weight of babies and BMI at the age of eight partially affected childhood asthma due to gestational weight gain. However, other studies found minimal effects on childhood BMI<a href="#accordion">[4]</a>. 
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Another research studied the relationship between maternal pre-pregnancy BMI, gestational diabetes, weight gain, and the risk of wheezing in preschool offspring. The focus was on the growth, infection, and atopic mechanism. 
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The age group of the children in the study was 1-4 years and it was observed that mothers who had a history of asthma, atopy, and pre-pregnancy obesity, had kids at risk of pre-school wheezing.&nbsp; 
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Moreover, whenever the standard gestational weight gain deviated, it increased the risk of preschool wheezing. The results were independent of pre-pregnancy BMI and no difference was seen in mothers with history of atopy or asthma<a href="#accordion">[5]</a>. Additionally, child growth or eczema did not change the results either. 
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An overall higher risk of pre-school wheezing was seen in offspring of mothers with obesity before pregnancy, history of atopy, asthma, and gestational weight gain. Neither of these could be explained by infectious or atopic mechanisms. However, further research might be able to identify what the underlying mechanisms are.

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Childhood asthma is one of the most common chronic respiratory diseases. Considering that the death rate of children by asthma is 0-0.7 per 100,000 around the world, it is a cause for global concern. Moreover, the annual prevalence of asthma in children is 9.5%, which is higher compared to the 7.7% seen in adults<a href="#accordion">[6]</a>. Therefore, new tools have been developed to target preventive strategies, and improve health. 
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Studies suggest that asthma in children is associated with maternal weight gain before and during pregnancy. Moreover, pre-pregnancy weight gain is a global issue; it jumped from 13% to 22% within a decade (1993-2003). Overall, it indicates an increase of 69%.&nbsp; 
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Unfortunately, numerous studies have examined the link between GWG and pre-pregnancy obesity with childhood asthma, and the results remain inconclusive.&nbsp;

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A healthy and balanced diet can help the baby get the required nutrients for a healthy growth. However, the question that is commonly asked is how much extra calories are even normal? Extra calories are helpful and required in some cases, but eating for two is not recommended.&nbsp; 
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However it is important to note that the below caloric add-ons are applicable if a woman&rsquo;s weight is within a normal range and is moderately active. In this case, the recommended daily intake before pregnancy would be about 2,000 calories a day.&nbsp;&nbsp; 
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The caloric intake in pregnant women depends on the time of the pregnancy. For example, slight increase is good enough for the first trimester, which then needs to increase to an additional 300 to 350 calories per day during the second trimester. In the third trimester, an additional 450 to 500 calories per day are needed. If you&#39;re carrying multiple pregnancies, you could need an additional 300 calories per day for each baby. 
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Pregnant women need to consult their healthcare providers to know how much weight they can gain. Women who have the ideal weight according to their BMI should be able to gain 25-35 pounds during pregnancy, whereas underweight women have a margin for 28-40 pounds. Overweight women can gain only 15-25 pounds when pregnant<a href="#accordion">[7]</a>. 
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So, the general rule is that women can gain 2-4 pounds in their first trimester and 1 pound per week for the remaining pregnancy. Besides, women who are expecting twins can gain 35-45 pounds, which makes it an average of 1.5 pounds per week after the usual first trimester weight gain. It is very important for women with twin pregnancy to gain the right weight.&nbsp;

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Conclusion

It is advised that prenatal healthcare providers evaluate maternal weight at every visit. They should also monitor weight goals and provide counselling accordingly. More than 50% of women tend to exceed their weight gain goals and become overweight, which is a serious health hazard. It leads to low birth weight, failure to produce breast milk, cesarean deliveries, and postpartum weight retention. Furthermore, the offspring can also be overweight and suffer from macrosomia. 
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Although gestational weight gain is potentially threatening to women and the offspring, it is a modifiable risk factor. Diet and exercise during pregnancy helps in reducing the extra weight. However, these interventions have not improved neonatal outcomes significantly, and the effects on obese women are also limited. Thus, indicating that its best to achieve a healthy BMI prior to conception.

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[1] Rogozińska, E., Zamora, J., Marlin, N., Betrán, A.P., Astrup, A., Bogaerts, A., Cecatti, J.G., Dodd, J.M., Facchinetti, F., Geiker, N.R. and Haakstad, L.A., 2019. Gestational weight gain outside the Institute of Medicine recommendations and adverse pregnancy outcomes: analysis using individual participant data from randomised trials. BMC pregnancy and childbirth, 19(1), pp.1-12.

[2] Kominiarek, M.A. and Peaceman, A.M., 2017. Gestational weight gain. American journal of obstetrics and gynecology, 217(6), pp.642-651.

[3] Rusconi, F. and Popovic, M., 2017. Maternal obesity and childhood wheezing and asthma. Paediatric respiratory reviews, 22, pp.66-71.

[4] Harskamp-van Ginkel, M.W., London, S.J., Magnus, M.C., Gademan, M.G. and Vrijkotte, T.G., 2015. A study on mediation by offspring BMI in the association between maternal obesity and child respiratory outcomes in the amsterdam born and their development study cohort. PLoS One, 10(10), p.e0140641.

[5] Leermakers, E.T., Sonnenschein-van der Voort, A.M., Gaillard, R., Hofman, A., de Jongste, J.C., Jaddoe, V.W. and Duijts, L., 2013. Maternal weight, gestational weight gain and preschool wheezing: the Generation R Study. European Respiratory Journal, 42(5), pp.1234-1243.

[6] Liu, S., Zhou, B., Wang, Y., Wang, K., Zhang, Z. and Niu, W., 2020. Pre-pregnancy maternal weight and gestational weight gain increase the risk for childhood asthma and wheeze: an updated meta-analysis. Frontiers in pediatrics, 8, p.134.

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