“Maternal complications in pregnancy and wheezing in early childhood”
25/04/2016
There is growing evidence of a relationship between early life factors and a wide range of chronic diseases in children and adults, including obstructive lung diseases and asthma. Relatively few studies have investigated whether maternal complications and conditions in pregnancy are associated with widely recognized problems such as wheezing and asthma in early childhood, and results are somewhat inconsistent.
The aim of this study was to assess the relationship of maternal hypertensive disorders of pregnancy, maternal diabetes and pre-pregnancy overweight and obesity with wheezing symptoms developing in the first two years of life in the offspring. These associations were investigated by combining data of more than 80000 subjects from 14 birth cohorts in Europe (4 of them were INMA cohorts: Gipuzkoa, Menorca, Sabadell and Valencia).
Researchers found that hypertensive disorders during pregnancy, in particular preeclampsia (defined as arterial hypertension and protein in urine after the 20th week of pregnancy and until eight weeks post-partum), and pre-pregnancy overweight and obesity are associated with an increased risk of developing wheezing disorders, mainly recurrent wheezing. In spite of the variability in the data when you compare the different cohorts, the results showed homogeneous effects across these cohorts indicating that the findings are robust.
These findings are important because other studies have shown that about 25{3effe4377b6f02be2524d084f7d03914ac32a2b62c0a056ca3444e58c1f10d0b} of children with persistent asthma start to wheeze in the first 6 months of age, and up to 75{3effe4377b6f02be2524d084f7d03914ac32a2b62c0a056ca3444e58c1f10d0b} by the age of three years. Wheezing of early onset has been also associated with an impairment of lung function that may track into adult life in susceptible individuals and that might predispose them to chronic respiratory diseases. Follow up studies at older ages than 2 years are needed in order to clarify the contribution of these maternal factors to wheezing persisting into school age, and to a diagnosis of asthma.
Reference: Zugna D, Galassi C, Annesi-Maesano I, Baïz N, Barros H, Basterrechea M, Correia S, Duijts L, Esplugues A, Fantini MP, Forastiere F, Gascon M, Gori D, Inskip H, Larsen PS, Mommers M, Nybo Andersen AM, Penders J, Petersen MS, Pike K, Porta D, Sonnenschein-van der Voort A, Steuerwald U, Sunyer J, Torrent M, Vrijheid M, Richiardi L, Rusconi F. Maternal complications in pregnancy and wheezing in early childhood: A pooled analysis of 14 birth cohorts. Int J Epidemiol. 2015 Feb;44(1):199-208.