Maternal asthma severity and control during pregnancy and risk of offspring asthma - 07/03/18
, Esben Agerbo, DrMedSci a, b, c, Vivi Schlünssen, MD, PhD d, e, Rosalind J. Wright, MD, MPH f, Jiong Li, PhD g, Trine Munk-Olsen, PhD aAbstract |
Background |
Severe and uncontrolled asthma during pregnancy has been linked to several unfavorable perinatal outcomes. However, current knowledge on the association between the severity and control of maternal asthma and offspring asthma is sparse.
Objective |
We sought to investigate the extent to which offspring asthma is influenced by maternal asthma severity and control during pregnancy.
Methods |
We performed a prospective population-based cohort study. Using linkage of Danish national registers, we constructed a cohort of 675,379 singletons, of which 15,014 children were born to asthmatic mothers. Among them, 7,188 children were born to mothers with active asthma during pregnancy. We categorized mothers with active asthma into 4 groups based on dispensed antiasthma prescriptions and on use of medical services: mild controlled, mild uncontrolled, moderate-to-severe controlled, and moderate-to-severe uncontrolled asthma. The outcomes were offspring early-onset transient, early-onset persistent, and late-onset asthma. We estimated prevalence ratios (PRs) of each phenotype of asthma using a log-binomial model with 95% CIs.
Results |
Higher prevalence of early-onset persistent asthma was observed among children of asthmatic mothers with mild uncontrolled (PR, 1.19; 95% CI, 1.05-1.35), moderate-to-severe controlled (PR, 1.33; 95% CI, 1.09-1.63), and moderate-to-severe uncontrolled asthma (PR, 1.37; 95% CI, 1.17-1.61) compared with those of mothers with mild controlled asthma. A borderline increased prevalence of early-onset transient asthma was observed among children of mothers with uncontrolled asthma.
Conclusion |
Maternal uncontrolled asthma increases the risk of early-onset persistent and transient asthma. If replicated, this could suggest that maintaining asthma control in pregnancy is an area for possible prevention of specific phenotypes of offspring asthma.
Le texte complet de cet article est disponible en PDF.Key words : Asthma, cohort study, control, early onset, late onset, phenotype, pregnancy, severity
Abbreviations used : ATC, ICD-8, ICD-10, PR
Plan
| Supported by the Danish Council for Independent Research (project no. DFF-5053-00156B). E.A. and T.M.-O. are supported by iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research (R155-2014-1724). E.A. is also supported by the Niels Bohr Professorship Grant from the Danish National Research Foundation and the Stanley Medical Research Institute. J.L. is supported by the Nordic Cancer Union (176673 and 186200), Danish Council for Independent Research (DFF-6110-00019), Karen Elise Jensens Fond (2016), and PROCRIN project. |
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| Disclosure of potential conflict of interest: R. J. Wright's institution received a grant from the National Institutes of Health for other works. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 141 - N° 3
P. 886 - mars 2018 Retour au numéro
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