The effect of asthma during pregnancy on placental function and fetal development

哮喘影响了12%的澳大利亚人口，预计在未来10年将增加到20%。这一增加将导致怀孕期间患哮喘的妇女人数增加，并可能成为一个重大的公共卫生问题，因为怀孕期间的哮喘与低出生体重婴儿有关。低出生体重本身是许多成人疾病（如糖尿病和冠状动脉疾病）的一个增加的风险因素，因此哮喘妇女的孩子在一生中面临许多疾病的风险。然而，导致哮喘妊娠低出生体重的具体机制尚不清楚。我们目前在这个重要领域处于领先地位。到目前为止，我们的数据表明，哮喘会导致胎盘血流量和糖皮质激素代谢的改变，当胎儿是女性时，这种改变尤为明显。吸入糖皮质激素治疗对哮喘对胎儿的影响具有保护作用，提示炎症途径的参与。我们工作的长期目标是阐明哮喘对胎儿健康的影响，并设计更好的方法来管理妊娠期间哮喘，以改善婴儿的结局。这项资助的短期目标是确定妊娠期间与哮喘相关的炎症因子是否会改变胎盘功能从而对胎儿发育产生不利影响，以及这些影响是否与胎儿的性别有关。这些研究的完成将提供科学和临床结果。科学上，一个生物学基础的理解改变胎盘生理观察妇女哮喘将产生。在临床上，我们的工作将为优化这组妇女的治疗开辟道路，以改善她们的妊娠和婴儿的结局。

Asthma affects 12% of the Australian population and is expected to increase to 20% over the next 10 years. This rise will result in an increase in the number of women who suffer from asthma during pregnancy and could emerge as a major public health problem since asthma during pregnancy is associated with low birthweight babies. Lower birthweight itself is an increased risk factor for a number of adult diseases such as diabetes and coronary artery disease and thus the children of asthmatic women are at risk for numerous pathologies throughout life. Nevertheless, the specific mechanisms that cause low birthweight in asthmatic pregnancies are unknown. We currently have a lead in this important area. Our data so far indicates that asthma produces alterations in placental blood flow and glucocorticoid metabolism that are particularly pronounced when the fetus is female. Inhaled glucocorticoid therapy is protective of the effects of asthma on the fetus suggesting the involvement of inflammatory pathways. The long term objectives of our work are to elucidate the effects of asthma on fetal health and to design better ways to manage asthma during pregnancy to improve the outcome for the baby. The short term objective of this grant is to define whether inflammatory factors associated with asthma during pregnancy change placental function to adversely affect fetal development and whether these effects are related to the sex of the fetus. Completion of these studies will provide both scientific and clincial outcomes. Scientifically, a biological basis for understanding alterations in placental physiology observed in women with asthma will be produced. Clinically our work will open avenues to optimize therapy for this group of women to improve their pregnancy and the outcome for their babies.