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Maternal asthma is associated with increased risk of perinatal mortality.

ABSTRACT: BACKGROUND:Asthma is the most common chronic disease during pregnancy and it may have influence on pregnancy outcome. OBJECTIVES:Our goal was to assess the association between maternal asthma and the perinatal risks as well as possible effects of asthma medication. METHODS:The study was based on a nationwide Finnish register-based cohort between the years 1996 and 2012 in the Drug and Pregnancy Database. The register data comprised 962 405 singleton live and stillbirths, 898 333 (93.3%) pregnancies in mothers with neither confirmed asthma nor use of asthma medication (controls), and 26 674 (2.8%) pregnancies with confirmed maternal asthma. 71% of mothers with asthma used asthma medication. The diagnosis of asthma was based on the mothers' right for subsidised medication which is carefully evaluated by strict criteria including pulmonary function testing. Odds ratio was used in comparison. Premature birth (PB), low birth weight, small for gestational age (SGA), neonatal death were the main outcome measures. RESULTS:Maternal asthma was associated with adjusted odds ratios (aORs) for perinatal mortality 1.24 (95% CI 1.05 to 1.46), preterm birth 1.18 (1.11 to 1.25), low birth weight 1.29 (1.21 to 1.37), fetal growth restriction (SGA) 1.32, (1.24 to 1.40), and asphyxia 1.09 (1.02 to 1.17). Asthma treatment reduced the increased risk of preterm birth aOR 0.85 (95% CI 0.76 to 0.96) but mothers with treated asthma had higher risks of fetal growth restriction (SGA) aOR 1.26 (1.10 to 1.45), and asphyxia aOR 1.37 (1.17 to 1.61) than mothers with untreated asthma. CONCLUSION:Asthma is associated with increased risks of perinatal mortality, preterm birth, low birth weight, fetal growth restriction (SGA), and asphyxia. Asthma treatment reduces the risk of preterm delivery, but it does not seem to reduce other complications such as perinatal mortality.

SUBMITTER: Kemppainen M

PROVIDER: S-EPMC5959067 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Maternal asthma is associated with increased risk of perinatal mortality.

Kemppainen Mari M Lahesmaa-Korpinen Anna-Maria AM Kauppi Paula P Virtanen Martti M Virtanen Suvi M SM Karikoski Riitta R Gissler Mika M Kirjavainen Turkka T

PloS one 20180518 5

<h4>Background</h4>Asthma is the most common chronic disease during pregnancy and it may have influence on pregnancy outcome.<h4>Objectives</h4>Our goal was to assess the association between maternal asthma and the perinatal risks as well as possible effects of asthma medication.<h4>Methods</h4>The study was based on a nationwide Finnish register-based cohort between the years 1996 and 2012 in the Drug and Pregnancy Database. The register data comprised 962 405 singleton live and stillbirths, 89 ...[more]

PMID: 29775476

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Project description:ObjectivePositive family history is associated with increased type 2 diabetes (T2D) risk, and reflects both genetic and environmental risks. Several studies have suggested an excess maternal transmission of T2D, although the underlying mechanism is unknown. We aimed to examine the association between maternal diabetes and cardiometabolic risk in the offspring.MethodsParental history of diabetes and clinical data including anthropometric traits, fasting plasma glucose and insulin (FPG, FPI), blood pressure and lipid profile were collected from 2581 unrelated Chinese offspring (2026 adolescents from a population-based school survey and 555 adults from a community-based health screening programme). A subset of subjects (n=834) underwent oral glucose tolerance test to measure the glucose and insulin concentrations at 0, 15, 30, 60 and 120 min for evaluation of the areas under the curve (AUC) of glucose and insulin at 0-120 min, homoeostasis model assessment of insulin resistance (HOMA-IR) and bell-cell function, insulinogenic index, insulin sensitivity index (ISI) and oral disposition index (DI).ResultsA positive parental history of diabetes was associated with increased risk of obesity (odd ratios (OR) (95% confidence interval (CI))=1.48 (1.10-2.00)), central obesity (OR (95% CI)=1.67 (1.21-2.32)), higher FPI, HOMA-IR, 2-h insulin, AUC of glucose at 0-120 min, triglycerides, reduced ISI and DI. Compared with individuals without parental diabetes, offspring with diabetic mother had significantly increased risk of obesity (OR (95% CI)=1.59 (1.07-2.35)), central obesity (OR (95% CI)=1.88 (1.23-2.88)), higher glucose levels and BP, were more insulin resistant but also had impaired first-phase insulin response and worse lipid profile. However, paternal history of diabetes had no effect on any of the studied traits, except higher body mass index, waist circumference in females and FPG.ConclusionsOur findings suggested that maternal history of diabetes conferred increased risk of cardiometabolic abnormalities, and was associated with both insulin resistance and impaired first-phase insulin secretion. Further investigation into the mechanism of transgenerational diabetes is warranted.

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Maternal asthma is associated with increased risk of perinatal mortality.

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Maternal asthma is associated with increased risk of perinatal mortality.

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