Maternal asthma during pregnancy and risks of allergy and asthma in progeny: A systematic review and meta‐analysis

Author:

Roff Andrea J.12ORCID,Robinson Joshua L.13,Hammond Sarah J.14,Bednarz Jana56,Tai Andrew17,Clifton Vicki L.8,Morrison Janna L.4,Gatford Kathryn L.12

Affiliation:

1. Robinson Research Institute University of Adelaide Adelaide South Australia Australia

2. School of Biomedicine University of Adelaide Adelaide South Australia Australia

3. Adelaide Medical School University of Adelaide Adelaide South Australia Australia

4. Early Origins of Adult Health Research Group, Health and Biomedical Innovation, UniSA: Clinical and Health Sciences University of South Australia Adelaide South Australia Australia

5. School of Public Health University of Adelaide Adelaide South Australia Australia

6. SAHMRI Women and Kids South Australian Health and Medical Research Institute North Adelaide South Australia Australia

7. Respiratory and Sleep Medicine Women's and Children's Hospital Adelaide South Australia Australia

8. Mater Medical Research Institute University of Queensland Brisbane Queensland Australia

Abstract

AbstractBackgroundClinical and preclinical evidence indicate that in utero maternal asthma exposure increases progeny asthma risk. Whether maternal asthma also increases the risks of progeny allergy is unclear.ObjectivesTo synthesise the available evidence on the relationship between in utero exposure to maternal asthma and postnatal asthma, wheezing and allergic diseases (Prospero: CRD42020201538).Search StrategyWe systematically searched MEDLINE [PubMed], Embase [Ovid], Web of Science, Informit Health, the Cochrane Library, CINAHL [EBSCOhost], MedNar [Deep Web Technologies], ProQuest Theses and Dissertations, Scopus [Elsevier] and Trove, to the end of 2023.Selection CriteriaStudies reporting asthma, wheeze and/or allergic disease in progeny of women with and without asthma or with asthma classified by control, exacerbation or severity.Data Collection and AnalysisDouble screening, selection, data extraction and quality assessment were performed, using Joanna Briggs Institute (JBI) scoring.Main ResultsOf 134 non‐overlapping studies, 127 were included in ≥1 meta‐analysis. Maternal asthma ever was associated with greater risks of asthma (65 studies, risk ratio [95% confidence interval] 1.76 [1.57–1.96]), wheeze (35 studies, 1.59 [1.52–1.66]), food allergy (5 studies, 1.32 [1.23–1.40]), allergic rhinitis (7 studies, 1.18 [1.06–1.31]) and allergic dermatitis (14 studies, 1.17 [1.11–1.23]) ever in progeny. Asthma during the pregnancy, more severe, and uncontrolled maternal asthma were each associated with greater risks of progeny asthma.ConclusionsChildren of mothers with asthma are at increased risk for the development of allergic diseases. Whether improved maternal asthma control reduces risks of child allergy as well as asthma requires further investigation.

Publisher

Wiley

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