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American Journal of Epidemiology Advance Access originally published online on April 8, 2009
American Journal of Epidemiology 2009 169(11):1337-1343; doi:10.1093/aje/kwp054
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Is the Association Between Low Birth Weight and Asthma Independent of Genetic and Shared Environmental Factors?

Eduardo Villamor, Anastasia Iliadou and Sven Cnattingius

Correspondence to Dr. Eduardo Villamor, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (e-mail: evillamo{at}hsph.harvard.edu).

Received for publication September 7, 2008. Accepted for publication February 13, 2009.

Epidemiologic evidence linking birth weight and asthma is inconsistent. The authors examined the association between birth weight and asthma during childhood and adult life in twins. Using prospectively collected data on 21,588 like-sexed Swedish twins of known zygosity born in 1928–1952, they first conducted a cohort study to examine the risk of asthma in relation to birth weight. Next, they conducted nested co-twin control analyses among 643 dizygotic and 365 monozygotic twin pairs discordant for asthma to ascertain whether the association between birth weight and asthma could be confounded by genetic and shared environmental exposures. In the cohort analysis, birth weight of <2,500 g was associated with significantly greater risk of asthma independent of perinatal characteristics and within-twin-pair correlations. In the co-twin control analyses, birth weight of <2,500 g was significantly related to increased risk of asthma among monozygotic twins (relative risk for 2,000 g vs. 2,500 g = 1.58, 95% confidence interval: 1.06, 2.38). A negative association between birth weight and asthma, albeit not statistically significant, was also found among dizygotic twins. In conclusion, there is a negative association between birth weight and asthma in twins that is unlikely to be confounded by genetic or shared environmental factors.

asthma; birth weight; confounding factors (epidemiology); twins

Abbreviations: CI, confidence interval; SALT, Screening Across the Lifespan Twin


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A. K. Ortqvist, C. Lundholm, E. Carlstrom, P. Lichtenstein, S. Cnattingius, and C. Almqvist
Familial Factors Do not Confound the Association Between Birth Weight and Childhood Asthma
Pediatrics, October 1, 2009; 124(4): e737 - e743.
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