Maternal pregestational or gestational diabetes and childhood wheezing: A population‐based cohort study

Liu, Xiaoqin; Agerbo, Esben; Li, Jiong; Dharmage, Shyamali C.; Thomsen, Reimar Wernich; Olsen, Jørn; Munk‐Olsen, Trine

doi:10.1111/all.13551

Cited by 14 publications

(23 citation statements)

References 10 publications

(9 reference statements)

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“…The inconsistency may also be related to sample size, and uncontrolled confounding factors, such as antenatal steroids and early‐life feeding, or exclusivity of breastfeeding. In the study of offspring wheezing, the results of Rusconi et al 28 (OR: 0.94, 95% CI: 0.47‐1.86) and Liu et al 30 (OR: 0.85, 95% CI: 0.67‐1.09) were inconsistent with ours (OR: 1.13, 95% CI: 1.07‐1.21). Only children with late‐onset wheezing were studied in both studies.…”

Section: Discussioncontrasting

confidence: 54%

“…The endpoints were set as transient early wheezing, persistent wheezing and late‐onset wheezing, 28 or ever wheezing and recurrent wheezing 29 . Since there were multiple subtypes of maternal diabetes (presentational type 1 diabetes, presentational type 2 diabetes, and gestational diabetes) and wheezing (early‐onset transient wheezing, early‐onset persistent wheezing, late‐onset wheezing), 9 sets of data were derived from Liu's study according to multiple combinations of maternal diabetes and wheezing 30 . Maternal diabetes mellitus was associated with the risk of wheezing in children, with a pooled effect estimate of 1.13 (95% CI: 1.07, 1.21) while the effect estimates of the wheezing's phenotypes were as followed: transient wheezing (OR: 1.14, 95% CI: 1.03‐1.25), early persistent wheezing (OR: 1.19, 95% CI: 1.11‐1.28), and late‐onset wheezing (OR: 1.01, 95% CI: 0.89‐1.14).…”

Section: Resultsmentioning

confidence: 99%

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Association between maternal diabetes mellitus and allergic diseases in children — A systematic review and meta‐analysis

Wang

et al. 2021

Pediatric Allergy Immunology

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Background Existing knowledge suggests that gestational diabetes mellitus was inconsistently associated with offspring allergic diseases. The aim of this study was to identify the association between maternal diabetes mellitus and the risk of offspring allergic diseases by systematic review. Methods We searched and retrieved three databases (PubMed, Web of Science, and Cochrane Library) for articles on the association between maternal diabetes mellitus and offspring allergic diseases published before December 31, 2019. Stata software version 16.0 was used for statistical analysis. Results Eight published studies were included in this meta‐analysis. The pooled effect estimates showed the association between maternal diabetes mellitus and allergic outcomes, including asthma (OR: 1.13, 95% CI: 1.01‐1.27), wheezing (OR: 1.13, 95% CI: 1.07‐1.21), and atopic dermatitis (OR: 1.43, 95% CI: 1.22‐1.57). Maternal diabetes mellitus was not associated with the risk of allergic sensitization, with a pooled effect estimate of 1.07 (95% CI: 0.45, 2.58). Conclusion Maternal diabetes mellitus may increase the risk of allergic diseases in their children. However, this finding should be validated with future large‐sample epidemiological studies covering a wider spectrum of allergic diseases.

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Section: Discussioncontrasting

confidence: 54%

Section: Resultsmentioning

confidence: 99%

Association between maternal diabetes mellitus and allergic diseases in children — A systematic review and meta‐analysis

Wang

et al. 2021

Pediatric Allergy Immunology

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“…4-6 years of age) (OR: 1.15 95% CI: 1.05, 1.26) 15. Similar to other European studies, the prevalence of GDM was low in this study at 1.5%.…”

supporting

confidence: 85%

“…While noting some inconsistencies, 14 several prior studies have reported positive associations between maternal diabetes and childhood respiratory outcomes. 15,16,[21][22][23][24][25][26] For example, several large European cohort studies have examined maternal diabetes and childhood wheeze 21,22 and asthma. [23][24][25] In general, these studies did not distinguish between pre-existing and gestational onset diabe- 16 While this study does support some association between GDM and child asthma, there appear to be differences in the magnitude of the point estimates when compared to ours.…”

Section: Discussionmentioning

confidence: 99%

Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort

Adgent

Gebretsadik

Reedus

et al. 2021

Pediatric Allergy Immunology

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Background: Childhood asthma is a common chronic disease that likely has prenatal origins. Gestational diabetes alters maternal physiology and may influence fetal risk for childhood-onset disease. However, the association between gestational diabetes and child asthma is not well characterized.Objective: To investigate the association between gestational diabetes and wheeze/ asthma at approximately 4 years of age in a racially diverse US cohort. Methods: We studied mother-child dyads enrolled prenatally in the ConditionsAffecting Neurocognitive Development and Learning in Early Childhood study.Gestational diabetes was determined by medical chart review. At approximately 4 years of age, we assessed child respiratory outcomes including parent report of physician-diagnosed asthma (ever), current wheeze (symptoms within the past 12 months), and current asthma (physician diagnosis and/or medication or symptoms within the past 12 months). We used the modified Poisson regression to assess associations between gestational diabetes and child respiratory outcomes, adjusting for maternal age, race, prenatal smoking, pre-pregnancy body mass index, parity, asthma history, socioeconomic status, and infant sex.Results: Among 1107 women, 66% were African American/Black. Six percent (n = 62) had gestational diabetes documented during pregnancy. Gestational diabetes was | 1191 ADGENT ET Al.

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“…Prenatal exposure to maternal diabetes has also been associated with congenital heart disease, obesity, and diabetes in offspring. These diseases could, in turn, lead to an increased risk of CVD in later life 1517181920. The offspring of mothers with diabetes also have a higher prevalence of metabolic syndrome and other risk factors for future CVD 92122.…”

Section: Introductionmentioning

confidence: 99%

Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

Arah

Liew

et al. 2019

BMJ

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188

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ObjectiveTo evaluate the associations between maternal diabetes diagnosed before or during pregnancy and early onset cardiovascular disease (CVD) in offspring during their first four decades of life.DesignPopulation based cohort study.SettingDanish national health registries.ParticipantsAll 2 432 000 liveborn children without congenital heart disease in Denmark during 1977-2016. Follow-up began at birth and continued until first time diagnosis of CVD, death, emigration, or 31 December 2016, whichever came first.Exposures for observational studiesPregestational diabetes, including type 1 diabetes (n=22 055) and type 2 diabetes (n=6537), and gestational diabetes (n=26 272).Main outcome measuresThe primary outcome was early onset CVD (excluding congenital heart diseases) defined by hospital diagnosis. Associations between maternal diabetes and risks of early onset CVD in offspring were studied. Cox regression was used to assess whether a maternal history of CVD or maternal diabetic complications affected these associations. Adjustments were made for calendar year, sex, singleton status, maternal factors (parity, age, smoking, education, cohabitation, residence at childbirth, history of CVD before childbirth), and paternal history of CVD before childbirth. The cumulative incidence was averaged across all individuals, and factors were adjusted while treating deaths from causes other than CVD as competing events.ResultsDuring up to 40 years of follow-up, 1153 offspring of mothers with diabetes and 91 311 offspring of mothers who did not have diabetes were diagnosed with CVD. Offspring of mothers with diabetes had a 29% increased overall rate of early onset CVD (hazard ratio 1.29 (95% confidence interval 1.21 to 1.37); cumulative incidence among offspring unexposed to maternal diabetes at 40 years of age 13.07% (12.92% to 13.21%), difference in cumulative incidence between exposed and unexposed offspring 4.72% (2.37% to 7.06%)). The sibship design yielded results similar to those of the unpaired design based on the whole cohort. Both pregestational diabetes (1.34 (1.25 to 1.43)) and gestational diabetes (1.19 (1.07 to 1.32)) were associated with increased rates of CVD in offspring. We also observed varied increased rates of specific early onset CVDs, particularly heart failure (1.45 (0.89 to 2.35)), hypertensive disease (1.78 (1.50 to 2.11)), deep vein thrombosis (1.82 (1.38 to 2.41)), and pulmonary embolism (1.91 (1.31 to 2.80)). Increased rates of CVD were seen in different age groups from childhood to early adulthood until age 40 years. The increased rates were more pronounced among offspring of mothers with diabetic complications (1.60 (1.25 to 2.05)). A higher incidence of early onset CVD in offspring of mothers with diabetes and comorbid CVD (1.73 (1.36 to 2.20)) was associated with the added influence of comorbid CVD but not due to the interaction between diabetes and CVD on the multiplicative scale (P value for interaction 0.94).ConclusionsChildren of mothers with diabetes, especially those mothers with a...

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Maternal pregestational or gestational diabetes and childhood wheezing: A population‐based cohort study

Cited by 14 publications

References 10 publications

Association between maternal diabetes mellitus and allergic diseases in children — A systematic review and meta‐analysis

Association between maternal diabetes mellitus and allergic diseases in children — A systematic review and meta‐analysis

Gestational diabetes and childhood asthma in a racially diverse US pregnancy cohort

Maternal diabetes during pregnancy and early onset of cardiovascular disease in offspring: population based cohort study with 40 years of follow-up

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