Intrapartum maternal asthma linked to increased disease in children

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1. Maternal asthma in pregnancy was associated with an increased risk of infectious and parasitic diseases, diseases of the nervous system, respiratory system, ear, and skin.

2. Associations between maternal asthma in pregnancy and offspring risk of malformations, endocrine disorders, and gastrointestinal disorders were investigated, but were not significant upon correction in secondary analysis.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Asthma is a common condition seen in pregnancy, affecting up to 8% of women of childbearing age. Previous studies have looked at short-term consequences of intrapartum asthma, suggesting that maternal asthma is associated with preeclampsia and increased risk of low birth weight, small for gestational age, and preterm infants. This large cohort study further explores the potential risk for long-term childhood diseases in offspring of asthmatic mothers. Researchers found these children to be at an increased risk of infectious and parasitic diseases, diseases of the nervous system, respiratory system, ear, and skin when compared to children of mothers without asthma. Associations between maternal asthma and offspring risk of malformations, endocrine disorders, and gastrointestinal disorders were not significant following analysis with secondary correction. It is proposed that maternal asthma and offspring disease may be linked by fetal hypoxia secondary to maternal hypoxia and upregulation of maternal cytokines and fetal cytokine expression. This study is limited by its inclusion of a homogenous population. Additionally, severity and medication usage in maternal asthma was not determined. Further research is indicated to better define the interaction between maternal asthma and childhood disease, ultimately  aiding in the development of preventative treatments.

Click to read the study, published today in Pediatrics 

Relevant Reading: A meta-analysis of adverse perinatal outcomes in women with asthma

In-Depth [prospective cohort study]: 66712 mother-child pairs from singleton deliveries during 1996-2012 were enrolled through the Danish National Birth Cohort. 6.2% of enrolled mothers self-reported having asthma during pregnancy. Offspring of asthmatic mothers and non-asthmatic maternal controls were followed for a median of 6.2 years (range: 3.6 – 8.9 years). Offspring of asthmatic mothers were at a significantly higher risk of infectious and parasitic diseases (HR 1.34), and diseases of the nervous system (HR 1.43), respiratory system (HR 1.43), ear (HR 1.33), and skin (HR 1.39) when compared to non-asthmatic maternal controls. Significant associations between maternal asthma during pregnancy and offspring malformations, endocrine disorders, and gastrointestinal disorders were found on primary analysis, but did not hold up upon secondary correction.

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