Asthma During Pregnancy and Clinical Outcomes in Offspring: A National Cohort Study

Tegethoff, Marion; Olsen, Jørn; Schaffner, Emmanuel; Meinlschmidt, Gunther

doi:10.1542/peds.2012-3686

Cited by 39 publications

(34 citation statements)

References 73 publications

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“…A study which observed H1N1 infection from April to September 2009 in Canada found pregnant women were hospitalized more frequently than the non-pregnant women, and preexisting lung disease or asthma increased the mortality risk of influenza A virus infection [32]. A Danish included more than 100,000 pregnant women during 7 years, and it was found that offspring of pregnant women with asthma have an increased risk of influenza A virus infection (HR=1.34; 95% CI: 1.23–1.46) [33]. …”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

Liu

et al. 2017

Kidney Blood Press Res

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Background/Aims: Impaired pregnancy outcomes, such as low birth weight are associated with increased disease risk in later life, however little is known about the impact of common infectious diseases during pregnancy on birth weight. The study had two aims: a) to investigate risk factors of influenza virus infection during pregnancy, and b) to analyze the impact of influenza virus infection on pregnancy outcome, especially birth weight. Methods: Prospective and retrospective observational studies found in PubMed, MEDLINE, Embase, Google Scholar, and WangFang database were included in this meta analysis. Data of included studies was extracted and analyzed by the RevMan software. Results: Pregnant women with anemia (P=0.004, RR=1.46, 95% CI: 1.13-1.88), obesity (P<0.00001, RR=1.35, 95% CI: 1.25-1.46) and asthma (P<0.00001, RR=1.99, 95% CI: 1.67-2.37) had higher rates of influenza virus infection. Regarding birth outcomes, influenza A virus infection did not affect the likelihood for cesarean section. Mothers with influenza had a higher rate of stillbirth (P=0.04, RR=2.36, 95% CI: 1.05-5.31), and their offspring had low 5-minute APGR Scores (P=0.009, RR=1.39, 95% CI: 1.08-1.79). Furthermore, the rate for birth weight < 2500g (P=0.04, RR=1.71, 95% CI: 1.03-2.84) was increased. Conclusion: Results of this study showed that anemia, asthma and obesity during pregnancy are risk factors influenza A virus infection during pregnancy. Moreover, gestational influenza A infection impairs pregnancy outcomes and increases the risk for low birth weight, a known risk factor for later life disease susceptibility.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

Liu

et al. 2017

Kidney Blood Press Res

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“…Moreover, active asthma in pregnancy has been linked to a number of adverse outcomes for the developing child, in addition to asthma development. (33) Thus, these findings have important implications for future studies of the intergenerational effects of stress, pregnancy, and child health more broadly.…”

Section: Discussionmentioning

confidence: 92%

“…(32, 33) No prior studies have considered chronic stress as an upstream factor that may increase the likelihood that asthma in women may be persistent and active in her childbearing years and during pregnancy. A woman’s exposure to chronic stressors could generate lasting biological changes in her immune and neuroendocrine systems that continue to exert their effects into adulthood and pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…(32, 33) While genetic predisposition likely plays a role in childhood asthma risk, numerous studies have shown that maternal active asthma during pregnancy has a direct effect on fetal development and a child’s respiratory health through restricted oxygenation, dysfunction of bronchial relaxation, cytokine expression, and placental sensitivity to cortisol and intrauterine glucocorticoid exposure. (33, 34) Other studies link trauma histories to pre-pregnancy obesity (35) and smoking during pregnancy. (36) Both maternal obesity and prenatal smoking have been linked to childhood asthma.…”

Section: Introductionmentioning

confidence: 99%

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Impact of Maternal Lifetime Interpersonal Trauma on Children's Asthma: Mediation Through Maternal Active Asthma During Pregnancy

et al. 2017

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Objective Traumatic stressors, including child abuse and/or interpersonal violence over a woman’s lifecourse, can affect the health of her children. This study examines associations between maternal lifetime interpersonal trauma (IPT) and children’s asthma by age six years (N=857). Methods Pregnant women completed the Revised Conflict Tactics Scale; IPT exposure was categorized as unexposed (55%), early (childhood and/or teen years only, 25%), late (adulthood and/or index pregnancy, 7%), and chronic (early and late, 13%). Clinician-diagnosed asthma in children was reported by mothers at each follow-up visit until the child reached age 6 years. We examined effects of maternal IPT categories and child’s asthma using logistic regression. Using structural equation models, we also examined indirect relationships between maternal chronic IPT and child asthma operating through active asthma in pregnancy, pre-pregnancy BMI, prenatal smoking, and/or increased exposure to other adverse life events or environmental toxins prenatally. Effect modification by the child’s sex was examined. Results Mothers were primarily Hispanic (55%) or Black (30%) with < high school education (62%). In logistic regression models, chronic maternal IPT (compared to unexposed) was associated with asthma in boys (OR=2.87; 95% CI, 1.48–5.57) but not girls (OR=0.69; 95% CI 0.23–2.12) (pinteraction=0.042). In SEMs, chronic IPT was associated with maternal active asthma in pregnancy (β=0.59, p<0.001); maternal active asthma was associated with children’s asthma (β=0.20, p=0.009); and the total indirect effect for this path was significant (β=0.12, p=0.031). Associations were most evident among boys. Conclusions Mothers’ history of chronic interpersonal trauma was associated with asthma in boys. This association was mediated through active maternal asthma in pregnancy.

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“…The Danish National Birth Cohort studied over 66 000 pregnant females from 1996 to 2002, with 6.2% of these females having asthma during pregnancy [11,12]. The children have been followed to the age of 3.6-8.9 years to assess the association between maternal asthma (with and without ICS use) and 17 diseases.…”

Section: Effects On Infant Healthmentioning

confidence: 99%

Asthma in pregnancy: a hit for two

Murphy

Schatz

2014

European Respiratory Review

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Asthma commonly occurs in pregnant females, and recent data have outlined the risks of adverse perinatal outcomes among this population. There is an increased risk of low birth weight and small for gestational age, particularly among females with moderate-to-severe asthma and exacerbations during pregnancy. There is also an increased risk of preterm birth, especially with oral steroid use, a small but statistically significant increased risk of congenital malformations, particularly of cleft lip with or without cleft palate, and an increased risk of neonatal hospitalisation and death. Active management may reduce these risks, possibly through reductions in exacerbations.Additional reassuring data have been presented for asthma medication use, which support the benefits outweighing the risks of indicated asthma medication use in pregnancy. Viral infections are an important trigger of asthma exacerbations in pregnancy, and recent data provides possible immunological changes that may explain this. Poor medication adherence despite worsening asthma symptoms in pregnancy is a problem which continues to be demonstrated in the literature. Improving asthma control in pregnancy has the potential to improve not only the mother's health but also that of her child. @ERSpublications Improving asthma control in pregnancy has the potential to improve the mother's health and that of her child

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Asthma During Pregnancy and Clinical Outcomes in Offspring: A National Cohort Study

Cited by 39 publications

References 73 publications

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

A Systematic Review and Meta-Analysis of Influenza A Virus Infection During Pregnancy Associated with an Increased Risk for Stillbirth and Low Birth Weight

Impact of Maternal Lifetime Interpersonal Trauma on Children's Asthma: Mediation Through Maternal Active Asthma During Pregnancy

Asthma in pregnancy: a hit for two

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