Background: The aetiological factors underlying the worldwide increase in the prevalence of asthma and the international patterns of the prevalence of asthma are not well understood. This has led to consideration of factors such as fetomaternal health which may programme the initial susceptibility to allergic sensitisation, or contribute to the development of asthma independently of sensitisation. Methods: A number of epidemiological studies have examined the relationship between birth anthropometric measures (as a marker of fetomaternal health) and the subsequent development of asthma and atopy in childhood or adult life. Results: Some, but not all of these studies have reported a relationship between enhanced fetal growth and an increased risk of asthma and/or atopy. Conclusion: These findings raise the hypothesis that factors responsible for fetal growth may also lead to programming of the developing respiratory or immune systems, predisposing to the subsequent development of asthma and/or atopy. This hypothesis may explain, in part, the increasing prevalence of asthma and atopy over recent decades, which has occurred concurrently with secular trends for improved fetomaternal health, as measured by anthropometric measurements at birth.

1.
Woolcock AJ, Peat JK: Evidence for the increase in asthma worldwide; in Ciba Foundation Symposium 206. The Rising Trends in Asthma. Chichester, Wiley, 1997, pp 122–134.
2.
ISAAC Steering Committee (Writing Committee: Beasley R, Keil U, Von Mutius E, Pearce N): Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis and atopic eczema: ISAAC. Lancet 1998;351:1225–1232.
3.
Godfrey KM, Barker DJP, Osmond C: Disproportionate fetal growth and raised IgE concentration in adult life. Clin Exp Allergy 1994;24: 641–648.
4.
Gregory A, Doull I, Pearce N, Cheng S, Leadbitter P, Holgate S, Beasley R: The relationship between anthropometric measurements at birth: Asthma and atopy in childhood. Clin Exp Allergy, in press.
5.
Fergusson DM, Crane J, Beasley R, Horwood LJ: Perinatal factors and atopic disease in childhood. Clin Exp Allergy 1997;27:1394– 1401.
6.
Leadbitter P, Pearce N, Cheng S, Sears MR, Holdaway M, Flannery EM, Herbison GP, Beasley R: The relationship between fetal growth and the development of asthma and atopy in childhood (abstract). Proceedings of the European Respiratory Society Annual Congress, Geneva, 1998.
7.
Schwartz J, Gold D, Dockery DW, Weiss ST, Speizer FE: Predictors of asthma and persistent wheeze in a national sample of children in the United States. Am Rev Respir Dis 1990; 142:555–562.
8.
Oliveti JF, Kercsmar CM, Redline S: Pre– and perinatal risk factors for asthma in inner city African–American children. Am J Epidemiol 1996;143:570–577.
9.
Bråbäck L, Hedberg A: Perinatal risk factors for atopic disease in conscripts. Clin Exp Allergy 1998;28:936–942.
10.
Barker DJP: Mothers, Babies, and Disease in Later Life. London, BMJ Publishing Group, 1994.
11.
Strauss SS: Effects of the intrauterine environment on childhood growth. Br Med Bull 1997; 53:81–95.
12.
Hay W: Current Topic: Metabolic Interrelationships of Placenta on the Fetus. Placenta 1995;16:19–30.
13.
Garnica AD, Chan W–Y: The role of the placenta in fetal nutrition and growth. J Am Coll Nutr 1996;15:206–222.
14.
Hornstra G, Al MD, Houwelingan AC, Foreman–van Dongelen M: Essential fatty acids in pregnancy and early human development. Eur J Obstet Gynecol Reprod Biol 1995;61:57–62.
15.
Leaf AA, Leighfield MJ, Costeloe KL, Crawford MA: Long chain polyunsaturated fatty acids and fetal growth. Early Hum Dev 1992; 30:183–191.
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