Asthma During Pregnancy - Are There Subsequent Risks For Baby?

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Academic Journal
Main Category: Pediatrics / Children's Health
Also Included In: Pregnancy / Obstetrics;  Respiratory / Asthma
Article Date: 16 Dec 2011 - 8:00 PST

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According to a novel investigation, inhaled glucocorticoids for treating women with asthma during pregnancy are not connected with increased risks of most diseases in children. However, the treatment might be a risk factor for metabolic and endocrine disturbances. The study is published online ahead of print publication in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

65,085 mothers and their children from the Danish National Birth Cohort were followed up from early pregnancy into childhood in a population-based cohort investigation. First author Marion Tegethoff, PhD, associate faculty member in clinical psychology and psychiatry at the University of Basel, Switzerland, explained:

"Maternal use of inhaled glucocorticoids for asthma during pregnancy was not related to an increased risk of most diseases in childhood, expect for endocrine and metabolic disorders, as compared to the risk in asthmatic mothers without glucocorticoid inhalation during pregnancy. Our data are mostly reassuring and support the use of inhaled glucocorticoids during pregnancy."

61,002 (93.7%) out of the 65,085 mother-child pairs with live singleton pregnancies experienced no asthma during pregnancy and 4083 (6.3%) had asthma during pregnancy. At the end of follow-up median age was 6.1 years (range: 3.6 to 8.9 years).

The researchers found in a statistical examination adjusted for baseline predictors of child health that inhaled glucocorticoid use was connected with a considerably increased risk for first diagnosis of endocrine and metabolic disorders (hazard ratio [HR], 1.84; 95% confidence interval [CI], 1.13-2.99).

This risk was not observed in diseases in any other category. The team discovered that when examinations were restricted to mother-child pairs exposed only to budesonide, the results were comparable. Budesonide - the inhaled glucocorticoid - was used by 79.9% of women in the investigation.

Last author Gunther Meinlschmidt, PhD, associate faculty member in clinical psychology and epidemiology at the University of Basel, Switzerland, explained:

"This is the first comprehensive study of potential effects of glucocorticoid inhalation during pregnancy on the health of offspring, covering a wide spectrum of pediatric diseases.

While our results support the use of these widely used asthma treatments during pregnancy, their effect on endocrine and metabolic disturbances during childhood merits further study."

The authors explained that there were some limits in this study, including insufficient data on daily inhalation doses, use of self-report of maternal asthma, as well as the investigation's focus on glucocorticoid inhalation, instead of other active components of glucocorticoids administered by other routes.

The researchers conclude:

"Our data have both clinical and public health implications given that asthma is common in pregnant women and inhaled glucocorticoids are the recommended treatment."

Written by Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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