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Published on: August 7, 2017
The association between hypertensive disorders of pregnancy and childhood asthma
Louise Kelly1, Peter Barrett2,3, Fergus P McCarthy3,4
1School of Public Health, University College Cork, Cork, Ireland. 113318366@umail.ucc.ie.
Insights
Hypertensive disorders of pregnancy (HDP) are linked to a higher risk of childhood asthma by age seven. This risk is even greater for children born preterm or small for gestational age (SGA).
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Epidemiology
Background:
- Asthma is a chronic respiratory condition posing a significant global health burden.
- Hypertensive disorders of pregnancy (HDP) represent a critical area of concern in maternal and child health.
- Existing research on the link between HDP and childhood asthma yields conflicting results, necessitating further investigation.
Purpose of the Study:
- To examine the association between exposure to hypertensive disorders of pregnancy (HDP) and the subsequent risk of asthma diagnosis in children up to seven years of age.
- To utilize the UK Millennium Cohort Study (MCS) data for a comprehensive analysis of this relationship.
- To identify specific risk factors, such as preterm birth or being small for gestational age (SGA), that may modify this association.
Main Methods:
- The study analyzed data from 18,552 families participating in the UK Millennium Cohort Study (MCS).
- Mothers self-reported hypertensive disorders of pregnancy (HDP) during the first wave when children were 9 months old.
- Childhood asthma was assessed via parent-reported diagnosis at age seven using a validated questionnaire.
Main Results:
- A statistically significant association was found between hypertensive disorders of pregnancy (HDP) and an increased odds of asthma diagnosis in offspring (AOR 1.35).
- The association was more pronounced in children exposed to HDP who were also born preterm (AOR 1.81).
- Children exposed to HDP and born small for gestational age (SGA) also showed a heightened risk of asthma (AOR 1.58).
Conclusions:
- Exposure to hypertensive disorders of pregnancy (HDP) may increase the likelihood of asthma diagnosis by age seven.
- The risk of childhood asthma is particularly elevated for infants exposed to HDP who are born preterm or small for gestational age (SGA).
- These findings highlight the importance of considering maternal pregnancy complications in the context of pediatric respiratory health.
Background:
Asthma is a chronic long-term inflammatory disease of the airways and is a major global health challenge. The primary aim of this study was to investigate the association between hypertensive disorders of pregnancy (HDP) and the risk of asthma at or before the age of seven years using the UK Millennium Cohort Study (MCS).
Methods:
Overall, 18,552 families were recruited for wave one of the MCS when the child was 9 months old, and subsequently participated in waves two, three and four when they were three, five and seven years respectively. HDP were self-reported by mothers in wave one. The primary outcome was a parent-reported diagnosis of "ever asthma" at seven years, based on responses to a validated questionnaire.
Results:
Following adjustment for a range of potential confounding factors, HDP was found to be associated with asthma in the offspring (adjusted odds ratio (AOR 1.35; 95% CI: 1.15-1.59)). A larger effect estimate was observed amongst children exposed to HDP and born preterm (AOR 1.81; 95% CI: 1.25-2.61) or small for gestational age (SGA) (AOR = 1.58; (95% CI: 1.15-2.18)).
Conclusions:
In conclusion, children exposed to HDP may be at increased odds of asthma diagnosis by age seven, particularly if they were born preterm or SGA.
Impact:
There is a paucity of data investigating the relationship between hypertensive disorders of pregnancy and childhood asthma, with recent studies showing conflicting results. Our study investigated this relationship using a large cohort with ample information on a wide range of confounding factors. Our study showed that individuals exposed to HDP may be at increased odds of asthma diagnosis by age seven years, particularly if they were also born SGA or preterm.
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