Maternal Asthma, its Control and Severity in Pregnancy, and the Incidence of Atopic Dermatitis and Allergic Rhinitis in the Offspring

• Published in: The Journal of pediatrics Vol. 155; no. 5; pp. 707 - 713.e1
• Main Authors: Martel, Marie-Josée, PhD, Beauchesne, Marie-France, PharmD, Malo, Jean-Luc, MD, Rey, Évelyne, MD, MSc, Perreault, Sylvie, PhD, Forget, Amélie, MSc, Blais, Lucie, PhD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01-11-2009; Elsevier
• Subjects: Adult; Age Distribution; Anti-Asthmatic Agents - therapeutic use; Asthma - diagnosis; Asthma - drug therapy; Asthma - immunology; Biological and medical sciences; Chronic obstructive pulmonary disease, asthma; Cohort Studies; Confidence Intervals; Dermatitis, Atopic - diagnosis; Dermatitis, Atopic - epidemiology; Dermatitis, Atopic - immunology; Female; Follow-Up Studies; General aspects; Humans; Incidence; Infant, Newborn; International Classification of Diseases; Male; Medical sciences; Miscellaneous; Multivariate Analysis; Pediatrics; Pneumology; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - drug therapy; Pregnancy Complications - immunology; Probability; Proportional Hazards Models; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quebec - epidemiology; Registries; Retrospective Studies; Rhinitis, Allergic, Perennial - diagnosis; Rhinitis, Allergic, Perennial - epidemiology; Rhinitis, Allergic, Perennial - immunology; Severity of Illness Index; Sex Distribution; Quebec; AR; AD; 95%CI; Atopic dermatitis; Allergic rhinitis; 95% confidence interval; Intra-nasal corticosteroids; HR; Hazard ratio; INS; Parental behavior; Allergy; Pediatrics; Skin disease; Nose disease; Rhinitis; Epidemiology; Atopy; Incidence; Maternal behavior; ENT disease; Bronchus disease; Female; Obstructive pulmonary disease; Woman; Public health; Human; Immunopathology; Lung disease; Respiratory disease; Asthma; Pregnancy; Progeny; Treatment
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2009.05.004

Objective To evaluate the relationship between maternal asthma, its level of control and severity during pregnancy, and atopic dermatitis (AD) and allergic rhinitis (AR) incidence in children. Study design A cohort of 26 265 singletons born to mothers with and without asthma (1990–2002) was constituted by use of 3 Quebec databases. Mothers with asthma had to have received ≥1 diagnosis and ≥1 prescription for asthma 2 years before or during pregnancy. Asthma control and severity during pregnancy was based on validated indexes. ICD-9 codes 691 and 477 allowed us to identify cases of AD and AR. Results Maternal asthma during pregnancy was associated with an increased AD risk (adjusted hazard ratio: 1.11, 95% confidence interval: 1.02-1.21), but not of AR (adjusted hazard ratio: 1.04, 95% confidence interval: 0.91-1.20) in children. Asthma control and severity were not associated with either outcome. Maternal AR and intranasal corticosteroid use during pregnancy increased the risk of childhood AR by 70% and 45%. Conclusions Children of mothers with asthma or AR during pregnancy should be closely monitored to diagnose and treat AD and AR as early as possible.