Asthma in Pregnancy May Have Long-Term Consequences for Offspring

August 06, 2013

By Megan Brooks

NEW YORK (Reuters Health) Aug 06 - Children of pregnant women who have asthma are at increased risk of a wide range of diseases in childhood, including infectious and parasitic diseases and diseases of the nervous system, ear, respiratory system, and skin, among others, according to a new study.

However, it should be noted that effect sizes in our study were "rather small to moderate" (all adjusted hazard ratios 1.43 or less), Dr. Gunther Meinlschmidt from the Department of Psychology at University of Basel, Switzerland, told Reuters Health.

"To which extent risks shall be discussed with a pregnant woman needs to be decided individually by the GP or other respective health care provider," he said.

Asthma affects up to 8% of all pregnant women and women of childbearing age, and maternal asthma during pregnancy is associated with an increased risk of adverse obstetric outcomes.

Dr. Meinlschmidt and colleagues assessed associations between maternal asthma and a range of childhood diseases in 66,712 mother-child pairs who were followed up from early pregnancy in a Danish population-based cohort study. A total of 4,145 women (6.2%) suffered from asthma during pregnancy.

The children were followed until a median age of 6.2 years (range 3.6 to 8.9 years).

Children of asthmatic mothers had about a 34% increased risk of infectious and parasitic diseases and a 43% increased risk of diseases of the nervous system and respiratory system, the investigators reported in Pediatrics. Their risk of ear and skin diseases was 33% and 39% higher, respectively.

Other potential risks for children of asthmatic mothers include endocrine and metabolic disorders (HR 1.26), diseases of the digestive system (HR 1.17), and malformations (odds ratio 1.13).

"To the best of our knowledge, this is the first study covering a wide spectrum of diseases during childhood to suggest that maternal asthma during pregnancy may be a risk factor of a wide range of pediatric diseases," the authors say.

"This corroborates the clinical relevance of asthma during pregnancy with regard to long-term consequences emerging beyond the perinatal period, thereby further emphasizing that careful medical and obstetric monitoring of the asthmatic pregnant woman and her developing fetus and child are highly warranted," they add.

Dr. Meinlschmidt told Reuters Health, "If possible, clinical practice shall be guided by up-to-date recommendations given by authorities, such as the NICE-guidelines in the UK etc. Notably, programs, such as the National Asthma Education and Prevention Program (NAEPP) have provided recommendations for managing asthma during pregnancy. Future updates of these and other guidelines on the topic may want to consider our (and other's findings), when recommending how to most appropriately monitor asthmatic pregnant women and their developing fetuses and children."

SOURCE: http://bit.ly/15KsZdG

Pediatrics 2013.

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