Cohort Study of Maternal Gestational Weight Gain, Gestational Diabetes, and Childhood Asthma.
Cohort Study of Maternal Gestational Weight Gain, Gestational Diabetes, and Childhood Asthma.
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关于母亲孕期体重增加(GWG)和妊娠期糖尿病(GDM)与儿童哮喘的关联的数据有限且不一致。我们的目标是在美国出生前队列中调查这些关联。分析包括马萨诸塞州综合医院母婴队列中登记的16,351对母婴(1998-2010)。数据通过链接产前检查/分娩的电子健康记录来获得，以确定BMI、GWG和GDM(国家糖尿病数据组织标准)，并确定儿童的哮喘发病率和过敏(特应性皮炎或过敏性鼻炎)。产前暴露与哮喘的相关性通过调整母亲特征的Logistic回归进行了评估。共有2306名儿童(14%)在5岁前患上哮喘。总体而言，未发现GWG和哮喘之间存在关联。妊娠期糖尿病与子代哮喘呈正相关(OR1.46，95%CI 1.14~1.88)。仅在妊娠早期体重指数在20到24.9 kg/m2之间的母亲中观察到妊娠期糖尿病和哮喘之间的关联(OR 2.31，CI 1.46~3.65，p交互作用0.02)。我们报告了关于产前暴露对哮喘的影响的新发现，包括患有妊娠期糖尿病的母亲的风险增加，特别是那些体重指数正常的母亲。这些发现支持加强针对更健康怀孕的干预措施，这也可能有助于儿童哮喘的预防。
Data on the association of maternal gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with childhood asthma are limited and inconsistent. We aimed to investigate these associations in a U.S. pre-birth cohort. Analyses included 16,351 mother–child pairs enrolled in the Massachusetts General Hospital Maternal-Child Cohort (1998–2010). Data were obtained by linking electronic health records for prenatal visits/delivery to determine BMI, GWG, and GDM (National Diabetes Data Group criteria) and to determine asthma incidence and allergies (atopic dermatitis or allergic rhinitis) for children. The associations of prenatal exposures with asthma were evaluated using logistic regression adjusted for maternal characteristics. A total of 2306 children (14%) developed asthma by age 5 years. Overall, no association was found between GWG and asthma. GDM was positively associated with offspring asthma (OR 1.46, 95% CI 1.14–1.88). Associations between GDM and asthma were observed only among mothers with early pregnancy BMI between 20 and 24.9 kg/m2 (OR 2.31, CI 1.46–3.65, p-interaction 0.02). We report novel findings on the impact of prenatal exposures on asthma, including increased risk among mothers with GDM, particularly those with a normal BMI. These findings support the strengthening of interventions targeted toward a healthier pregnancy, which may also be helpful for childhood asthma prevention.