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Published on: August 7, 2017
Maternal asthma severity and control during pregnancy and risk of offspring asthma
Xiaoqin Liu1, Esben Agerbo2, Vivi Schlünssen3
1The National Center for Register-based Research, Aarhus University, Aarhus, Denmark.
Insights
Maternal asthma uncontrolled during pregnancy increases offspring
Area of Science:
- Reproductive Health
- Pediatric Asthma
- Epidemiology
Background:
- Severe and uncontrolled asthma in pregnancy is linked to adverse perinatal outcomes.
- Limited data exists on maternal asthma's impact on offspring asthma development.
Purpose of the Study:
- To investigate how maternal asthma severity and control during pregnancy influence offspring asthma.
- To identify specific asthma phenotypes in offspring associated with maternal asthma status.
Main Methods:
- Prospective population-based cohort study using Danish national registers.
- Cohort of 675,379 singletons, with detailed analysis of 7,188 children born to mothers with active asthma.
- Maternal asthma categorized into four groups: mild/moderate-to-severe, controlled/uncontrolled, based on prescriptions and medical service use.
Main Results:
- Children born to mothers with mild uncontrolled, moderate-to-severe controlled, or moderate-to-severe uncontrolled asthma showed higher prevalence of early-onset persistent asthma.
- A borderline increased prevalence of early-onset transient asthma was noted in offspring of mothers with uncontrolled asthma.
Conclusions:
- Uncontrolled maternal asthma during pregnancy elevates the risk for early-onset persistent and transient asthma in offspring.
- Maintaining asthma control during pregnancy may be a strategy for preventing specific offspring asthma phenotypes.
Background:
Severe and uncontrolled asthma during pregnancy has been linked to several unfavorable perinatal outcomes. However, current knowledge on the association between the severity and control of maternal asthma and offspring asthma is sparse.
Objective:
We sought to investigate the extent to which offspring asthma is influenced by maternal asthma severity and control during pregnancy.
Methods:
We performed a prospective population-based cohort study. Using linkage of Danish national registers, we constructed a cohort of 675,379 singletons, of which 15,014 children were born to asthmatic mothers. Among them, 7,188 children were born to mothers with active asthma during pregnancy. We categorized mothers with active asthma into 4 groups based on dispensed antiasthma prescriptions and on use of medical services: mild controlled, mild uncontrolled, moderate-to-severe controlled, and moderate-to-severe uncontrolled asthma. The outcomes were offspring early-onset transient, early-onset persistent, and late-onset asthma. We estimated prevalence ratios (PRs) of each phenotype of asthma using a log-binomial model with 95% CIs.
Results:
Higher prevalence of early-onset persistent asthma was observed among children of asthmatic mothers with mild uncontrolled (PR, 1.19; 95% CI, 1.05-1.35), moderate-to-severe controlled (PR, 1.33; 95% CI, 1.09-1.63), and moderate-to-severe uncontrolled asthma (PR, 1.37; 95% CI, 1.17-1.61) compared with those of mothers with mild controlled asthma. A borderline increased prevalence of early-onset transient asthma was observed among children of mothers with uncontrolled asthma.
Conclusion:
Maternal uncontrolled asthma increases the risk of early-onset persistent and transient asthma. If replicated, this could suggest that maintaining asthma control in pregnancy is an area for possible prevention of specific phenotypes of offspring asthma.
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