Healthy maternal lifestyle during pregnancy reduces wheezing and rhinitis in infants

The current study followed a unique design in exploring not single environmental factors but the influence of different early-life exposure profiles on respiratory health. The researchers found that a healthy lifestyle of the mother during pregnancy was able to offset exposure to high levels of risk factors such as road traffic.
In the concept of the exposome, all environmental exposures from conception onwards are evaluated to understand their impact on health. This approach enhances the understanding of the causes of complex multifactorial diseases. The study presented by Dr Alicia Guillien (University of Grenoble Alpes, France) aimed to identify combined pregnancy and early-life urban and lifestyle exposure profiles and evaluated their influence on respiratory health in children [1]. In particular, the pre-natal period and early childhood seem to be critical windows of exposure that may influence life-long risks for impaired lung function. Associations between many environmental factors and respiratory diseases are demonstrated in scientific literature. “Most of these studies focus on only 1 exposure, while we know that all of these exposures could have a combined effect on health,” Dr Guillien explained. This was the rationale to comprehensively assess the role of early-life environmental factors on paediatric respiratory health. The researchers identified different profiles of exposure and associated the exposure profiles in the pre-and post-natal periods with children’s respiratory health.
Data came from the European HELIX cohort [2], and included 1,033 mother-child pairs (mean children’s age 8.1 years) who were exposed to different types of exposure (e.g. water disinfection by-products, traffic, climate, air pollutants, built environment, lifestyle, and road traffic noise). The researchers evaluated 38 risk factors of exposure during pregnancy and 84 factors in childhood. Respiratory outcomes were asthma (ever), wheezing (past 12 months), and rhinitis (past 12 months), all assessed through questionnaires and spirometry.

Results showed that 2 early-life exposure profiles were associated with lower levels of forced expiratory volume in 1 second (FEV₁) in childhood, compared with the ‘reference’ profile with globally low exposures:

• 1 exposure profile characterised by globally low exposure to all factors except high exposure to UV and high temperature. This profile was also associated with a higher risk of ever-asthma (odds ratio (OR) 2.93 (95% CI 1.36-6.31); P<0.01); and
• 1 profile characterised by high exposure to a built environment and road traffic.

Interestingly and unexpectedly, a profile characterised by a high level of exposure to all risk factors but a healthy lifestyle of the mother during pregnancy was associated with a decreased risk of wheezing (OR 0.38; (95%CI 0.18-0.77); P=0.01) and rhinitis (OR 0.64 (95%CI 0.39-1.05); P=0.08).
As Dr Guillien pointed out, a strength of this study is that assessing the combined effects through exposure profiles is in accordance with the multifactorial aetiology of asthma, allergy, and lung function. “This study highlights the need for studies with combined exposure to improve preventive strategies,” she concluded.

1. Guillien A. Profiles of pregnancy and early-life urban and lifestyle exposures and respiratory health in children. Abstract 882, ERS International Congress 2023, 9–13 September, Milan, Italy.
2. Vrijheid M, et al. Environ Health Perspect. 2014 Jun;122(6):535-44.

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Posted on 29 October 202329 October 2023