J Allergy Clin Immunol Pract. 2025 May 7:S2213-2198(25)00415-5. doi: 10.1016/j.jaip.2025.04.046. Online ahead of print.
ABSTRACT
BACKGROUND: Maternal asthma is a known risk factor for asthma and allergic diseases in children. However, there is a lack of data on the role of asthma phenotypes in the association with perinatal outcomes.
OBJECTIVE: To investigate the role of maternal asthma in adverse perinatal outcomes, such as preterm birth (PTB), low-birthweight (LBW), and cesarean (C-section) deliveries.
METHODS: This cohort study included all singleton live-birth pregnancies in Alberta between October 2009 and December 2018. Maternal asthma was defined by the International Classification of Diseases codes (ICD-9/10: 493/J45) and was categorized by (i) status – ever (>1 year before pregnancy), current (within 1 year or during pregnancy), and active (during delivery hospitalization) asthma, and (ii) phenotypes – high (H) or low (L) blood (B) eosinophil (E) and neutrophil (N) counts. PTB (gestational age at delivery <37 weeks), LBW (≤2500 g), and C-section were the main perinatal outcomes of interest.
RESULTS: Of 434,068 pregnancies, 37,394 (8.6%) women had asthma, of which 52%, 40%, and 7% had ever, current, and active asthma, respectively. In adjusted analysis, maternal asthma was associated with increased risks of PTB (aRR: 1.15; 95%CI: 1.11-1.20), LBW (aRR: 1.11; 95%CI: 1.07-1.16), and C-section (aRR: 1.10; 95%CI: 1.08-1.12), and the risks were highest in active asthma, followed by current and ever asthma. The risk of PTB, LBW, and C-section were higher in the HBE/HBN phenotype, followed by HBN/LBE, HBE/LBN, and LBE/LBN phenotypes.
CONCLUSION: Women with any history of asthma, but particularly those with current and active asthma, are at higher risk of PTB, LBW, and C-sections.
PMID:40345327 | DOI:10.1016/j.jaip.2025.04.046
