Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children.
BACKGROUND
There is increasing interest in the potential influence of fetal and early life conditions on childhood wheezing.


OBJECTIVE
To investigate the associations between maternal complications and procedures in pregnancy and at birth and the risk of various wheezing phenotypes in young children.


METHODS
We studied 15,609 children, aged 6-7 yr, enrolled in a population-based study. Standardized questionnaires were completed by the children's mothers.


RESULTS
Of the children, 9.5% (1,478) had transient early wheezing, 5.4% (884) had persistent wheezing, and 6.1% (948) had late-onset wheezing. Maternal hypertension or preeclampsia was associated with an increased risk of all three wheezing phenotypes (for transient early wheezing: odds ratio [OR], 1.40; 95% confidence interval [95% CI], 1.08-1.82; for persistent wheezing: OR, 1.59; 95% CI, 1.15-2.19; and for late-onset wheezing: OR, 1.47; 95% CI, 1.06-2.01). Use of antibiotics for urinary tract infections was associated with transient early wheezing (OR, 1.52; 95% CI, 1.16-2.00), whereas antibiotic administration at delivery was associated with both transient early wheezing (OR, 1.21; 95% CI, 1.01-1.46) and persistent wheezing (OR, 1.39; 95% CI, 1.10-1.75). Children who had a mother with diabetes were also more likely to have persistent wheezing (OR, 1.72; 95% CI, 0.99-3.00). Neither amniocentesis/chorionic villus sampling, nor weight gain in pregnancy, nor cesarean section was associated with the subsequent development of wheezing. Maternal asthma or atopy was not an effect modifier of the associations found.


CONCLUSIONS
Some maternal complications during pregnancy and at delivery may increase the risk of developing different phenotypes of wheezing in childhood.
Rusconi
Franca
F
Epidemiology Unit, Anna Meyer Children's Hospital, Via Luca Giordano 7/m, 50132 Florence, Italy. f.rusconi@meyer.it
Galassi
Claudia
C
Forastiere
Francesco
F
Bellasio
Marta
M
De Sario
Manuela
M
Ciccone
Giovannino
G
Brunetti
Luigia
L
Chellini
Elisabetta
E
Corbo
Giuseppe
G
La Grutta
Stefania
S
Lombardi
Enrico
E
Piffer
Silvano
S
Talassi
Fiorella
F
Biggeri
Annibale
A
Pearce
Neil
N
D002648:Child; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000601:surgery; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors