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Maternal asthma and lung function, childhood asthma and growth: the MAESTRO-Child study
Emma Caffrey Osvald1,2, Cecilia Lundholm1, Bronwyn K Brew1,3
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Insights
Maternal asthma and allergic asthma increase the risk of childhood asthma. However, better maternal lung function during pregnancy may reduce this risk. Maternal health during pregnancy did not impact childhood growth.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Pulmonology
Background:
- Maternal asthma is linked to adverse child health outcomes, including childhood asthma and low birth weight.
- Understanding the impact of maternal respiratory health on offspring is crucial for preventative strategies.
Purpose of the Study:
- To investigate the association between maternal asthma, allergic asthma, and lung function with childhood asthma and growth.
- To determine if maternal respiratory health influences the development of asthma in children.
Main Methods:
- A Swedish pregnancy cohort (MAESTRO) linked to child and national health data (529 mother-child pairs).
- Maternal lung function (FEV1, FVC, FEV1/FVC, bronchodilator response) measured during pregnancy.
- Childhood asthma and growth assessed via questionnaires and register data; maternal asthma and allergic asthma defined using specific criteria.
Main Results:
- Maternal allergic asthma significantly increased the risk of childhood asthma by age 6 (adjRR 2.07).
- Higher pre- and post-bronchodilator FEV1 in mothers was associated with a reduced risk of childhood asthma (adjRR 0.50 and 0.45, respectively).
- No significant associations were found between maternal lung function parameters (FVC, FEV1/FVC, bronchodilator response) and childhood growth.
Conclusions:
- Maternal asthma, particularly allergic asthma, is a significant risk factor for childhood asthma.
- Improved maternal lung function during pregnancy may offer a protective effect against childhood asthma development.
- Maternal asthma and lung function did not show a statistically significant association with offspring growth.
Aim:
Maternal asthma is associated with childhood asthma and low birthweight. We investigated whether maternal asthma, allergic asthma and lung function are associated with childhood asthma and growth.
Method:
Data from a Swedish pregnancy cohort (Maternal Asthma Events Stress and Offspring (MAESTRO)) were linked to data from children (MAESTRO-Child) and to national health registers (529 mother-child pairs). Pre- and post-bronchodilator forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC and bronchodilator response were measured in pregnancy. Maternal asthma, childhood asthma and childhood growth (at birth, 6, 12, 18 and 36 months) were defined from self/parent-reported questionnaires and/or register data. Maternal allergic asthma was defined as asthma and allergic sensitisation (positive PhadiatopTM in pregnancy). Associations between maternal asthma, allergic asthma or lung function and childhood asthma and growth were estimated using multivariable regression models.
Results:
For maternal allergic asthma, there was an increased risk of "asthma ever by 6 years" (adjusted risk ratio (adjRR) 2.07, 95% confidence interval (CI) 1.33-3.22). Increasing pre- and post-bronchodilator FEV1 was associated with a reduced risk for childhood asthma (adjRR 0.50, 95% CI 0.30-0.81 and 0.45,95% CI 0.29-0.69, respectively for "asthma ever by 6 years"). No significant relationship was found for FVC, FEV1/FVC, bronchodilator response or between maternal measures and childhood growth.
Conclusion:
Maternal asthma and allergic asthma are risk factors for childhood asthma. Higher lung function in pregnancy may be associated with a lower risk for childhood asthma in the offspring. Maternal measures did not have a statistically significant association with childhood growth in the offspring.
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