B WELL MOM ANALYSIS 2020

B-WELL-Mom研究是一项多中心前瞻性队列研究，旨在增加对妊娠期哮喘控制不良预测因素的了解，并增加我们对妊娠基本免疫学的了解。 哮喘是一种常见的慢性疾病。它影响了100名孕妇中的9名，并与不良妊娠结局有关。我们知道，三分之一的哮喘孕妇在整个怀孕期间症状恶化，而三分之一的症状改善。然而，这种变化的原因尚不清楚。 母体对妊娠的免疫反应表明，体液免疫反应是保留的，过敏可能是决定哮喘孕妇临床病程的一个重要预测因素。我们将深入研究免疫功能和肺部炎症，以评估整个妊娠期和产后期间免疫调节过程的影响，这些影响可能与哮喘控制的变化有关。每天暴露在空气污染物中对母体免疫系统提出了另一个挑战，无论是患有哮喘还是没有哮喘的女性。在哮喘患者中，严重程度/控制的变化可能受到外部因素的不同影响，包括空气污染和饮食抗氧化剂。 这项研究将招募总共500名怀孕前三个月（小于14周妊娠）的妇女，并跟踪她们产后4个月。招募的目标是200名哮喘控制良好的妇女和200名怀孕前一年哮喘控制不佳的妇女，以及100名非哮喘妇女。 B-WELL-Mom研究由DIPHR流行病学分支与位于伯明翰的亚拉巴马大学和西北大学的两个临床中心、埃姆斯公司的数据协调中心、NICHD储存库和实验室合作进行。 400多名妇女参加了该项目，其中300多人于2018年6月分娩。 入组将于2018年8月结束，产后随访预计将于2019年9月结束。

The B-WELL-Mom Study, a multicenter prospective cohort study, aims to increase understanding of factors that predict poor asthma control during pregnancy, and that add to our knowledge of the basic immunology of pregnancy. Asthma is a common chronic disease. It affects about 9 out of 100 pregnant women and is associated with adverse pregnancy outcomes. We know that one-third of all pregnant women with asthma experience worsening symptoms throughout pregnancy, while one-third improve. However, the reason for this change is not known. The maternal immune response to pregnancy suggests that humoral immune responses are preserved, and that allergy may be an important predictor in determining the clinical course of pregnant women with asthma. We will examine in-depth immune function and lung inflammation to assess the impact of immune regulatory processes throughout pregnancy and the postpartum period that may be associated with changes in asthma control. Daily exposure to air pollutants provides another challenge to the maternal immune system, both for women with and without asthma. Among asthmatics, the change in severity/control may be differentially affected by external factors including air pollution and dietary antioxidants. This study will recruit a total of 500 women in their first trimester of pregnancy (less than 14 weeks gestation) and follows them through 4 months postpartum. Recruitment will target 200 women with good asthma control and 200 women with poorly controlled asthma in the year prior to pregnancy, in addition to 100 non-asthmatic women. The B-WELL-Mom Study is being conducted by the DIPHR Epidemiology Branch in collaboration with two clinical centers at the University of Alabama at Birmingham, and Northwestern University; a Data Coordinating Center at the Emmes Corporation; the NICHD Repository; and a laboratory. Over 400 women are enrolled and more than 300 of them had delivered by June 2018. Enrollment will end in August 2018 and postpartum follow-up visits are expected to end in September 2019.