Xiaoqin Liu1, Esben Agerbo2, Vivi Schlünssen3, Rosalind J Wright4, Jiong Li5, Trine Munk-Olsen6. 1. The National Center for Register-based Research, Aarhus University, Aarhus, Denmark. Electronic address: lxq@econ.au.dk. 2. The National Center for Register-based Research, Aarhus University, Aarhus, Denmark; CIRRAU-Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark. 3. Section for Environmental and Occupational Medicine, Department of Public Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark. 4. Department of Pediatrics, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY. 5. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 6. The National Center for Register-based Research, Aarhus University, Aarhus, Denmark.
Abstract
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.
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.
Authors: Hooman Mirzakhani; Vincent J Carey; Robert Zeiger; Leonard B Bacharier; George T O'Connor; Michael X Schatz; Nancy Laranjo; Scott T Weiss; Augusto A Litonjua Journal: Clin Exp Allergy Date: 2019-01-03 Impact factor: 5.018
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Authors: Kourtney G Gardner; Tebeb Gebretsadik; Terryl J Hartman; Maria J Rosa; Frances A Tylavsky; Margaret A Adgent; Paul E Moore; Mehmet Kocak; Nicole R Bush; Robert L Davis; Kaja Z Lewinn; Rosalind J Wright; Kecia N Carroll Journal: J Allergy Clin Immunol Pract Date: 2019-10-15
Authors: Hooman Mirzakhani; Vincent J Carey; Thomas F McElrath; Weiliang Qiu; Bruce W Hollis; George T O'Connor; Robert S Zeiger; Leonard Bacharier; Augusto A Litonjua; Scott T Weiss Journal: Am J Respir Crit Care Med Date: 2019-01-01 Impact factor: 30.528