PURPOSE OF THE STUDY.
The goal of this study was to determine the associations between asthma during pregnancy and the offspring’s risk of a wide variety of childhood diseases.
Birth data between 1996 and 2002 were prospectively collected from the Danish National Birth Cohort; 66 712 mother–child pairs were eligible and completed the study. Mothers had given birth to live singletons, most were aged >27 years, they had a medium to high socioeconomic status, were in average to very good health, were multiparous, and ∼25% of the women reported smoking. A total of 4145 (6.2%) had a diagnosis of self-reported asthma during their pregnancy.
Computer-assisted interviews at ∼12 and 30 weeks’ gestation and at 6 months’ postpartum were used to gather information about maternal asthma. Information on the children’s diseases was obtained from the Danish National Hospital Register. Cox and logistic regression models were used to analyze the associations between asthma during pregnancy and the risk of offspring disease, as well as controlling for potential confounders.
Offspring were followed up for mean of 6.2 years (range: 3.6–8.9 years). Positive associations included an increased risk of infectious and parasitic diseases (hazard ratio [HR]: 1.34 [95% confidence interval (CI): 1.23–1.46]) and diseases of the nervous system (HR: 1.43 [95% CI: 1.18–1.73), ear (HR: 1.33 [95% CI: 1.19–1.48]), respiratory system (HR 1.43 [95% CI: 1.34–1.52]), and skin (HR: 1.39 [95% CI: 1.20–1.60]). Potential associations not confirmed by analysis included endocrine and metabolic disorders (HR: 1.26 [95% CI: 1.02–1.55]), digestive system diseases (HR: 1.17 [95% CI: 1.04–1.32]), and congenital malformations (odds ratio: 1.13 [95% CI: 1.01–1.26]). There was no noted increased risk between maternal asthma and neoplasm, mental disorders, or diseases of the blood and immune system, circulatory system, musculoskeletal system, and genitourinary system.
The observed associations may be secondary to maternal hypoxia restricting fetal oxygenation, increase in cytokine exposure, or dysregulation of the hypothalamic-pituitary-adrenal axis. Results suggest the importance of monitoring and evaluating for maternal asthma during pregnancy and continuing to carefully follow up the offspring postnatally.
This study assessed maternal asthma and its long-term consequences on the offspring. A large patient cohort with prospectively collected data and the inclusion of medically verified diagnoses significantly strengthened the results. Asthma severity information was not assessed by spirometry or the use of asthma controller medications, nor did the study examine the number of maternal asthma exacerbations during the prenatal and perinatal periods. The association between maternal asthma and childhood diseases emphasizes the importance of monitoring the infant postnatally, as well as through childhood, for these diseases.
- Copyright © 2014 by the American Academy of Pediatrics