The Journal of Pediatrics
Volume 155, Issue 5 , Pages 707-713.e1, November 2009

Maternal Asthma, its Control and Severity in Pregnancy, and the Incidence of Atopic Dermatitis and Allergic Rhinitis in the Offspring

  • Marie-Josée Martel, PhD

      Affiliations

    • Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
  • ,
  • Marie-France Beauchesne, PharmD

      Affiliations

    • Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
    • Pharmacy Department, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
  • ,
  • Jean-Luc Malo, MD

      Affiliations

    • Research Center, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
  • ,
  • Évelyne Rey, MD, MSc

      Affiliations

    • Obstetric and Gynecology Department, CHU Ste-Justine, Montréal, Québec, Canada
  • ,
  • Sylvie Perreault, PhD

      Affiliations

    • Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
  • ,
  • Amélie Forget, MSc

      Affiliations

    • Research Center, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
  • ,
  • Lucie Blais, PhD

      Affiliations

    • Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
    • Corresponding Author InformationReprint requests: Lucie Blais, PhD, Université de Montréal, Faculté de Pharmacie, C.P. 6128, succursale Centre-ville, Montréal, Québec, Canada H3C 3J7.

Received 6 September 2008; received in revised form 11 February 2009; accepted 5 May 2009. published online 21 July 2009.

Objective

To evaluate the relationship between maternal asthma, its level of control and severity during pregnancy, and atopic dermatitis (AD) and allergic rhinitis (AR) incidence in children.

Study design

A cohort of 26 265 singletons born to mothers with and without asthma (1990–2002) was constituted by use of 3 Quebec databases. Mothers with asthma had to have received ≥1 diagnosis and ≥1 prescription for asthma 2 years before or during pregnancy. Asthma control and severity during pregnancy was based on validated indexes. ICD-9 codes 691 and 477 allowed us to identify cases of AD and AR.

Results

Maternal asthma during pregnancy was associated with an increased AD risk (adjusted hazard ratio: 1.11, 95% confidence interval: 1.02-1.21), but not of AR (adjusted hazard ratio: 1.04, 95% confidence interval: 0.91-1.20) in children. Asthma control and severity were not associated with either outcome. Maternal AR and intranasal corticosteroid use during pregnancy increased the risk of childhood AR by 70% and 45%.

Conclusions

Children of mothers with asthma or AR during pregnancy should be closely monitored to diagnose and treat AD and AR as early as possible.

AD, Atopic dermatitis, AR, Allergic rhinitis, HR, Hazard ratio, INS, Intra-nasal corticosteroids, 95%CI, 95% confidence interval

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 Funding and conflict of interest information available at www.jpeds.com (Appendix).

PII: S0022-3476(09)00473-9

doi:10.1016/j.jpeds.2009.05.004

The Journal of Pediatrics
Volume 155, Issue 5 , Pages 707-713.e1, November 2009