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Maternal asthma during pregnancy and the likelihood of neurodevelopmental disorders in offspring
Mari Kemppainen1, Mika Gissler2,3,4,5, Turkka Kirjavainen6
1Wellbeing Services County of Vantaa and Kerava, Kivistö Health Station, Vantaa, Finland.
Insights
Maternal asthma showed a weak association with offspring neurodevelopmental disorders, particularly learning disabilities, ADHD, motor development, and autism. The absolute prevalence differences were small, indicating a minimal impact overall.
Area of Science:
- Reproductive Health
- Pediatric Neurology
- Epidemiology
Background:
- Asthma is a prevalent chronic condition in pregnant individuals.
- Maternal asthma is linked to adverse pregnancy outcomes and potential neurodevelopmental issues in offspring.
- Previous studies suggest a connection between maternal asthma and neurodevelopmental disorders.
Purpose of the Study:
- To investigate the association between maternal asthma and the risk of neurodevelopmental disorders in offspring.
- To examine if asthma medication use during pregnancy influences this association.
- To differentiate associations between allergic and non-allergic asthma phenotypes.
Main Methods:
- A retrospective population-based cohort study.
- Included over 1.27 million mother-child pairs from Finland (1996-2018).
- Utilized multiple high-coverage registers and adjusted Cox regression models.
Main Results:
- Maternal asthma was associated with increased risks for ADHD, autism, motor, language, learning, and intellectual disabilities.
- Hazard ratios ranged from 1.12 to 1.51, with small absolute prevalence differences.
- No significant differences were observed between allergic and non-allergic asthma phenotypes.
Conclusions:
- Maternal asthma, including allergic and non-allergic types, shows a weak association with offspring neurodevelopmental disorders.
- The strongest associations were observed for learning disabilities, ADHD, motor development disorders, and autism.
- The findings suggest a need for further research into the underlying mechanisms.
Introduction:
Asthma is the most common chronic disease during pregnancy. Maternal asthma has been associated with a multitude of unwanted pregnancy outcomes, in some studies also with neurodevelopmental disorders. Here we investigated associations between maternal asthma and neurodevelopmental disorders.
Material And Methods:
We studied a retrospective population-based cohort of 1 271 439 mother-child pairs from singleton live births in Finland between the years 1996-2018. We used multiple high-cover registers for data collection. Adjusted unconditional Cox regression models were used to investigate associations between maternal asthma, asthma medication used during pregnancy, and offspring's neurodevelopmental disorder diagnoses.
Results:
We identified 106 163 mother-child pairs affected by maternal asthma. We found that maternal asthma was associated with offspring neurodevelopmental disorders, but the differences in absolute prevalence between the control and exposure groups were small. Attention-deficit hyperactivity disorder (ADHD) was found in 4114 (3.9%) offspring with maternal asthma and in 32 122 (3.0%) controls (adjusted hazard ratio (HR): 1.49; 95% CI 1.44-1.54); autism in 1617 (1.5%) offspring vs 13 701 (1.3%) controls (HR: 1.33; 95% CI 1.26-1.40); motor-developmental disorder in 1569 (1.5%) offspring vs 12 147 (1.1%) controls (HR: 1.37; 95% CI 1.30-1.45); language disorder in 3057 (2.9%) offspring vs 28 421 (2.7%) controls (HR: 1.13; 95% CI 1.08-1.17), learning disabilities in 849 (0.8%) offspring vs 6534 (0.6%) controls (HR: 1.51; 95% CI 1.41-1.62); mixed developmental disorder in 1633 (1.5%) offspring vs 14 434 (1.3%) controls (HR 1.20; 95% CI, 1.14-1.26); and intellectual disability in 908 (0.9%) vs 9155 (0.9%) controls (HR: 1.12; 95% CI 1.04-1.20). No substantial differences were found between allergic and non-allergic asthma phenotypes, and neither allergic tendency nor respiratory infection was associated with a similar likelihood of neurodevelopmental disorders.
Conclusions:
Maternal asthma and allergic and non-allergic phenotypes showed weak associations with the offspring's neurodevelopmental disorders. The association is concerned especially with learning disabilities, ADHD, motor development, and autism.
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