Maternal Fatty Acids, Child Obesity, and Asthma Immunity

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Matthew W. Gillman, MD, SM, Harvard Pilgrim Health Care
ClinicalTrials.gov Identifier:
NCT00088257
First received: July 23, 2004
Last updated: December 12, 2013
Last verified: December 2013
  Purpose

To study pre- and post-natal influences on the development of childhood asthma-related immune responses.


Condition
Asthma
Lung Diseases

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Prospective
Official Title: Maternal Fatty Acids, Child Obesity, and Asthma Immunity

Resource links provided by NLM:


Further study details as provided by Harvard Pilgrim Health Care:

Primary Outcome Measures:
  • Markers of allergy and inflammation at age 3 years [ Time Frame: Age 3 years ] [ Designated as safety issue: No ]
    Allergy-specific and total plasma IgE levels; asthma-related pro-inflammatory cytokines


Enrollment: 411
Study Start Date: August 2004
Study Completion Date: April 2009
Primary Completion Date: April 2009 (Final data collection date for primary outcome measure)
Groups/Cohorts
Mother-child pairs
Subset of mother-child pairs enrolled in Project Viva, a cohort study of pregnant women and their offspring. 411 mother-child pairs with measures of lymphocyte proliferation in their cord blood samples make up the subset for this study.

Detailed Description:

BACKGROUND:

Since most cases of asthma occur in the first few years of life, examining its pre- and early postnatal determinants is crucial. This study focuses on determinants of the developing immune system. T helper cells are of two types. Th1 cells participate in cell-mediated immunity essential for controlling intracellular infectious agents such as bacterial and viruses. Th2 cells are essential for antibody-mediated immunity to control extracellular infectious agents. The Th2 pattern, characterized by higher levels of IgE, increased production of proinflammatory cytokines such as interleukin-4 (IL-4) or IL-13, and decreased production of interferon-gamma (IFN-gamma), predominates prenatally. If it is not balanced by a Thl pattern after birth, e.g., increased IFN-7 production, risk of asthma likely increases. Early childhood immune mechanisms associated with risk of asthma may also involve non-IgE/Th2 pathways, with increased production of IL-6 or TNF-alpha. Preliminary studies have linked asthma at various ages with reduced ratio of n-3 to n-6 polyunsaturated fatty acids, increased birth weight, and overweight. Preliminary data have also linked these dietary and weight variables to systemic production of IgE and both Th2 and non-Th2 proinflammatory cytokines. Thus allergy and inflammation may be pathways through which pre- and early postnatal dietary factors influence development of asthma. However, there are virtually no prospective human data linking maternal diet or fetal/early childhood growth with the asthma-related immune response in childhood.

The study takes advantage of the resources of Project Viva, an ongoing NIH-funded prospective cohort study of pregnant women and their offspring in eastern Massachusetts. Project Viva already includes detailed dietary data on mother and infant, maternal and cord blood samples, and data on anthropometric, social, environmental, demographic, economic, psychological, and lifestyle variables. Relevant covariates are included, such as presence and severity of atopic diseases in the parents, parental smoking, infant respiratory infections, and infant environment.

DESIGN NARRATIVE:

The study examines associations of maternal gestational n-3 and n-6 fatty acid intake, fatty acid levels in umbilical cord blood, fetal growth, and early childhood overweight with markers of allergy and inflammation at the age of 3 years. These markers include allergy-specific and total plasma IgE levels and levels of proinflammatory cytokines from antigen- and mitogen-stimulated lymphocytes. This study takes advantage of the resources of Project Viva, an ongoing NIH-funded prospective cohort study of pregnant women and their offspring. Project Viva already includes detailed dietary data on mother and infant, maternal and cord blood samples, and data on anthropometric, social, environmental, demographic, economic, psychological, and lifestyle variables. This study supports several elements not otherwise funded, including adding measurement of immune outcomes at age 3 years in a subset of 370 cohort participants. Given the existing infrastructure of Project Viva, the study provides a relatively economical way to address scientific questions of major public health importance.

  Eligibility

Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Pregnant women were recruited in 1999-2002 following their initial prenatal visit at one of eight obstetric offices of a multi-specialty group practice in eastern MA.

Criteria

Women were eligible for participation in Project Viva if they:

  1. Were <22 weeks pregnant
  2. Planned to receive prenatal care at one of the selected clinics
  3. Planned to deliver at one of the two study hospitals
  4. Were able to answer questions in English

Women were ineligible if they:

  1. Planned to terminate their pregnancy
  2. Planned to move from the local area before the end of the follow-up period
  3. Were pregnant with multiples (twins, triplets, etc)

Project Viva mother-child pairs were eligible for this study if they had provided maternal dietary date during pregnancy and a cord blood sample at delivery on which lymphocyte proliferation had been measured.

  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00088257

Sponsors and Collaborators
Harvard Pilgrim Health Care
Investigators
Principal Investigator: Matthew Gillman Harvard Pilgrim Health Care
  More Information

No publications provided

Responsible Party: Matthew W. Gillman, MD, SM, Professor, Department of Population Medicine, Harvard Pilgrim Health Care
ClinicalTrials.gov Identifier: NCT00088257     History of Changes
Other Study ID Numbers: 1264, R01HL075504
Study First Received: July 23, 2004
Last Updated: December 12, 2013
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Asthma
Lung Diseases
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases

ClinicalTrials.gov processed this record on September 18, 2014