The impact of maternal asthma on the fetal lung: Outcomes, mechanisms and interventions

Area of Science:

• Obstetrics and Gynecology
• Pediatric Pulmonology
• Immunology

Background:

• Maternal asthma affects up to 17% of pregnancies.
• Associated with increased risks of neonatal respiratory distress, childhood wheeze, and asthma in offspring.
• Poor outcomes are linked to maternal asthma's influence on the in-utero environment, affecting fetal lung and immune development.

Purpose of the Study:

• To review mechanisms linking maternal asthma to offspring respiratory morbidities.
• To describe pregnancy interventions promoting optimal fetal lung development in babies of asthmatic mothers.

Main Methods:

• Literature review focusing on maternal asthma, fetal development, and offspring respiratory health.
• Analysis of potential mechanisms including impaired glucocorticoid signaling and increased fetal exposure to proinflammatory cytokines.
• Exploration of beneficial interventions such as maternal asthma control and vitamin supplementation.

Main Results:

• Maternal asthma may impair fetal glucocorticoid signaling, crucial for lung maturation.
• Increased fetal exposure to proinflammatory cytokines is a potential mechanism.
• Vitamin A, C, and D supplementation may enhance alveologenesis and surfactant production.

Conclusions:

• Maternal asthma significantly impacts fetal lung and immune development, predisposing offspring to respiratory diseases.
• Pregnancy interventions targeting maternal asthma control, glucocorticoid signaling, or nutritional support show promise for improving fetal lung development.
• Optimizing the in-utero environment is key to mitigating long-term respiratory risks in offspring of asthmatic mothers.