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Early-Life Origins and Prediction of Childhood Asthma
Tarik Karramass ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This doctoral thesis looks at how early-life factors relate to childhood asthma, the most common chronic disease in children worldwide. It uses data from Dutch birth cohorts (Generation R and Generation R Next), a cohort of preschool children with recurrent wheezing, and a European and Australian cohort network. It examines embryonic and fetal growth, prenatal exposure to bisphenols and phthalates, and the development of models to predict childhood asthma. The author concludes that these early-life factors are linked to breathing health from infancy into adolescence, and that early-life data can be used to build useful prediction models.
Key points
- Variation in embryonic and fetal growth is associated with respiratory health from infancy into adolescence.
- Prenatal exposure to bisphenols and phthalates (endocrine-disrupting chemicals) is associated with respiratory and lung function outcomes.
- Early-life characteristics can be used to build clinically meaningful prediction models for childhood asthma.
- The findings support the importance of the earliest stages of development, from the embryonic period onward, for the origins of asthma.
- Such prediction tools may eventually help with earlier identification, monitoring and personalised care for children at risk.
Limitations
Only the abstract is available, so there are no effect sizes, sample sizes or details on how well the prediction models perform. The studies are observational, so the reported associations do not show that the exposures cause asthma, and most of the data come from Dutch and other high-income settings.
Abstract
This thesis addresses the early-life origins and prediction of childhood asthma, the most common chronic disease in children worldwide. Asthma imposes a substantial burden on affected children, their families, and healthcare systems, and its origins are increasingly understood to extend back to the earliest stages of prenatal development. According to the Developmental Origins of Health and Disease (DOHaD) concept, adverse exposures and growth patterns during critical windows of fetal life can permanently alter organ structure and function, thereby programming the risk of disease later in life. Building on this concept, this thesis aimed to examine (1) whether embryonic and fetal growth patterns are associated with birth outcomes and respiratory health in early childhood, (2) whether prenatal exposure to bisphenols and phthalates, common endocrine-disrupting chemicals, is associated with respiratory and lung function outcomes from infancy to adolescence, and (3) whether early-life characteristics can be used to develop and validate prediction models for childhood asthma. To address these aims, data were used from the Generation R study and the Generation R Next study, two population-based prospective cohorts based in Rotterdam, the Netherlands, the WHEEP study, a multicenter cohort of preschool children with recurrent wheezing followed in secondary care, and the EU Child Cohort Network, an international collaboration of pregnancy and birth cohorts across Europe and Australia. The studies in this thesis show that variation in embryonic and fetal growth, and prenatal exposure to bisphenols and phthalates, are associated with respiratory health from infancy into adolescence, and that early-life characteristics can be used to build clinically meaningful prediction models for childhood asthma. Together, these findings support the relevance of the earliest stages of development, from the embryonic period onward, for the origins of childhood asthma, and illustrate how early-life data can be translated into tools that may ultimately contribute to earlier identification, monitoring, and personalized care for children at risk of asthma.