Published ahead of print on April 1, 2004, doi:10.1164/rccm.200307-1002OC
Am. J. Respir. Crit. Care Med., Volume 170, Number 3, August 2004, 260-265
A more recent version of this article appeared on August 1, 2004
Submitted on July 28, 2003
Accepted on March 26, 2004
Maternal Atopic Disease Modifies Effects of Prenatal Risk Factors on Exhaled Nitric Oxide in Infants
Urs Frey1*, Claudia Kuehni2, Hanna Roiha1, Mateja Cernelc1, Benjamin Reinmann1, Johannes H Wildhaber3, and Graham L Hall4
1 Swiss Pediatric Respiratory Research Group, University Hospital of Berne, Berne, Switzerland,
2 Swiss Pediatric Respiratory Research Group, University Hospital of Berne, Berne, Switzerland; Department of Social and Preventive Medicine, University of Berne, Berne, Switzerland,
3 Department of Pediatric Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland,
4 Swiss Pediatric Respiratory Research Group, University Hospital of Berne, Berne, Switzerland; Department of Pediatric Respiratory Medicine, University Hospital of Zurich, Zurich, Switzerland
* To whom correspondence should be addressed. E-mail: urs.frey{at}insel.ch.
In a prospective healthy birth cohort we determined whether levels of eNO in healthy unselected infants at the age of one month were associated with maternal atopic disease and pre- and early postnatal environmental exposures. Tidal exhaled NO (eNO) was measured in 98 healthy, unsedated infants (35 from atopic mothers) (mean age (SD) 36.0 (6.2) days) and compared to history taken in standardised interviews. eNO was higher in males compared to females (17.7 vs. 14.6 ppb, p=0.042) and in infants exposed to postnatal maternal smoking (+4.4 ppb, p=0.027), adjusting for weight and tidal breathing parameters. Prenatal tobacco exposure was associated with higher eNO (+12.0 ppb, p=0.01) in infants of asthmatic and lower eNO (-5.7 ppb) in infants of non-asthmatic mothers (p for interaction <0.0001). Coffee consumption in pregnancy decreased eNO (-6.0 ppb, p=0.008) only in children of atopic mothers (p for interaction 0.015). Paternal atopy had no influence. In the early phase of immuno-development, prior to the onset of infections and allergic disease, the effect of prenatal or early postnatal environmental factors on eNO is modified by the presence of maternal atopic disease. This underlines the complex interaction of maternal and environmental factors in the development of airway disease.
Key words: nitric oxide, infants, atopy, smoking, caffeine
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