Association of Maternal History of Allergic Features with Preterm Pregnancy Outcomes in the Japan Environment and Children’s Study

Abstract

Introduction: Previous studies have reported that maternal asthma increases the risk of preterm birth. We hypothesized that inflammatory reactions caused by allergic diseases might affect the uterine environment and, subsequently, perinatal outcomes. The objective of this study was to examine the associations between allergic features among mothers and preterm pregnancy outcomes in a nationwide birth cohort. Methods: We analyzed data from pregnant women obtained from the Japanese Environment and Children’s Study (JECS), a nationwide general birth cohort study. We used binomial and multinomial logistic regression models to examine the associations between maternal allergic features and preterm birth, threatened preterm labor (TPL), and preterm premature rupture of the membrane (PPROM). Results: A total of 97,683 pregnant women were included. Prevalence of preterm birth, TPL, and PPROM was 4.7, 19.6, and 1.2%, respectively. Maternal history of allergic diseases (asthma, allergic rhinitis, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of TPL(adjusted odds ratio [aOR] = 1.11 [95% CI: 1.06–1.17], aOR = 1.12 [1.08–1.16], aOR = 1.10 [1.04–1.16], aOR = 1.17 [1.09–1.26], aOR = 1.35 [1.23–1.48], and aOR = 1.34 [1.20–1.49], respectively). Although some maternal allergic features showed a negative association with preterm birth, the variables affecting preterm birth differed according to the gestational age of the fetus (22–33 weeks vs. 34–36 weeks). There were no significant associations between maternal allergic features and PPROM. Conclusion: Maternal allergic disease, except atopic dermatitis, may increase the risk of TPL. Comorbidity of maternal allergic disorders and perinatal adverse outcomes require further investigation.

Association between preterm birth and maternal allergy considering IgE level

“…6 In addition, they found a maternal history of allergic conjunctivitis and AD decreased the risk of early PTB and late PTB, respectively. 6 During pregnancy, immunological deviation, a shift from T-helper (Th) cell type 1-dominated to Th2-dominated immune responses was found to prevent fetal rejection. [8][9][10] Allergic disease is also Th2-biased, and IgE is an alternative marker for Th2-biased immune responses.…”

“…Previous studies showed that maternal BA was associated with an increased risk of adverse obstetric outcomes, including preterm birth (PTB) 4 . However, associations between other maternal allergic diseases, including AD and AR, and adverse obstetric outcomes have rarely been reported 5,6 . Saito et al .…”

“…4 However, associations between other maternal allergic diseases, including AD and AR, and adverse obstetric outcomes have rarely been reported. 5,6 Saito et al reported the associations between maternal allergic features, including BA, AD and AR, and small for gestational age 7 and preterm pregnancy outcomes. 6 They found a maternal history of allergic diseases (BA, AR, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of preterm labor (PTL).…”

“…5,6 Saito et al reported the associations between maternal allergic features, including BA, AD and AR, and small for gestational age 7 and preterm pregnancy outcomes. 6 They found a maternal history of allergic diseases (BA, AR, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of preterm labor (PTL). 6 In addition, they found a maternal history of allergic conjunctivitis and AD decreased the risk of early PTB and late PTB, respectively.…”

“…6 They found a maternal history of allergic diseases (BA, AR, allergic conjunctivitis, food allergy, drug allergy, and contact dermatitis) increased the risk of preterm labor (PTL). 6 In addition, they found a maternal history of allergic conjunctivitis and AD decreased the risk of early PTB and late PTB, respectively. 6 During pregnancy, immunological deviation, a shift from T-helper (Th) cell type 1-dominated to Th2-dominated immune responses was found to prevent fetal rejection.…”