B WELL MOM ANALYSIS 2020

B-Well-Ma研究是一项多中心前瞻性队列研究，旨在增加对预测怀孕期间哮喘控制不佳的因素的了解，并增加我们对怀孕基本免疫学的知识。 哮喘是一种常见的慢性病。大约每100名孕妇中就有9人受到影响，并与不良妊娠结局有关。我们知道，所有患有哮喘的孕妇中，三分之一的人在整个怀孕期间症状恶化，而三分之一的人症状有所改善。然而，这一变化的原因尚不清楚。 孕妇对妊娠的免疫反应表明体液免疫反应被保存下来，过敏可能是决定孕妇哮喘临床病程的重要预测因素。我们将深入检查免疫功能和肺部炎症，以评估整个妊娠和产后免疫调节过程的影响，这可能与哮喘控制的变化有关。每天暴露在空气污染物中给母亲的免疫系统带来了另一个挑战，对患有和没有哮喘的妇女都是如此。在哮喘患者中，严重程度/控制的变化可能会受到外部因素的不同影响，包括空气污染和饮食中的抗氧化剂。 这项研究将招募500名怀孕前三个月(怀孕不到14周)的妇女，并在产后4个月内对她们进行跟踪调查。招募对象将是怀孕前一年哮喘控制良好的200名妇女和哮喘控制不佳的200名妇女，以及100名非哮喘妇女。 DIPHR流行病学分部正在与阿拉巴马大学伯明翰分校和西北大学的两个临床中心、Emmes公司的一个数据协调中心、NICHD资料库和一个实验室合作进行B-Well-Ma研究。 有400多名妇女注册，截至2018年6月，其中300多人已经分娩。报名将于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.