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.

中文翻译：

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孕期孕妇哮喘的严重程度和控制以及后代哮喘的风险

背景

妊娠期间严重且不受控制的哮喘与几种不良的围产期结局有关。但是，目前关于母体哮喘和后代哮喘的严重程度和控制之间的关联的知识很少。

客观的

我们试图研究母体哮喘的严重程度和怀孕期间的控制对后代哮喘的影响程度。

方法

我们进行了一项基于人群的前瞻性队列研究。利用丹麦国家注册簿的链接，我们建立了一个675,379个单身人士的队列，其中有15,014名儿童是哮喘母亲所生。其中，有7188名儿童是怀孕期间患有活动性哮喘的母亲所生。根据分配的抗哮喘处方和医疗服务的使用，我们将患有活动性哮喘的母亲分为4组：轻度控制，轻度未控制，中度至重度控制以及中度至重度未控制哮喘。结果是后代早期发作短暂性，早期发作持续性和晚期发作哮喘。我们使用具有95％CI的对数二项式模型估算了每种哮喘表型的患病率（PRs）。

结果

在患有轻度未控制（PR，1.19； 95％CI，1.05-1.35），中至重度控制（PR，1.33； 95％CI，1.09-1.63）的哮喘母亲的儿童中，观察到早发持续性哮喘的患病率较高。 ），以及中度至重度未控制的哮喘（PR，1.37； 95％CI，1.17-1.61），与轻度控制哮喘的母亲相比。在患有不受控制的哮喘的母亲的儿童中，观察到早期发作的短暂性哮喘的患病率升高。

结论

孕妇不受控制的哮喘会增加早期发作的持续性和短暂性哮喘的风险。如果复制，这可能表明维持妊娠哮喘的控制是可能预防后代哮喘特定表型的领域。