title: Neonatal health of infants born to mothers with asthma.
abstract: BACKGROUND
  Maternal asthma is associated with serious pregnancy complications, but newborn morbidity is understudied.
  
  
  OBJECTIVE
  We wanted to determine whether infants of asthmatic mothers have more neonatal complications.
  
  
  METHODS
  The Consortium on Safe Labor (2002-2008), a retrospective cohort, included 223,512 singleton deliveries at ≥ 23 weeks' gestation. Newborns of mothers with asthma (n = 17,044) were compared with newborns of women without asthma by using logistic regression models with generalized estimating equations to calculate adjusted odds ratios (ORs) and 95% CIs. Electronic medical record data included gestational week at delivery, birth weight, resuscitation, neonatal intensive care unit (NICU) admission, NICU length of stay, hyperbilirubinemia, respiratory distress syndrome, apnea, sepsis, anemia, transient tachypnea of the newborn, infective pneumonia, asphyxia, intracerebral hemorrhage, seizure, cardiomyopathy, periventricular or intraventricular hemorrhage, necrotizing enterocolitis, aspiration, retinopathy of prematurity, and perinatal mortality.
  
  
  RESULTS
  Preterm delivery was associated with maternal asthma for each week after 33 completed weeks of gestation and not earlier. Maternal asthma also increased the adjusted odds of small for gestational age (OR = 1.10; 95% CI, 1.05-1.16), NICU admission (OR = 1.12; 95% CI, 1.07-1.17), hyperbilirubinemia (OR = 1.09; 95% CI, 1.04-1.14), respiratory distress syndrome (OR = 1.09; 95% CI, 1.01-1.19), transient tachypnea of the newborn (OR = 1.10; 95% CI, 1.02-1.19), and asphyxia (OR = 1.34; 95% CI, 1.03-1.75). Findings persisted for term infants (≥ 37 weeks) who had additional increased odds of intracerebral hemorrhage (OR = 1.84; 95% CI, 1.11-3.03) and anemia (OR = 1.30; 95% CI, 1.04-1.62).
  
  
  CONCLUSIONS
  Maternal asthma was associated with prematurity and small for gestational age. Adverse neonatal outcomes, including respiratory complications, hyperbilirubinemia, and NICU admission, were increased in association with maternal asthma even among term deliveries.
authors.affiliation: Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Rockville, Md. Electronic address: pauline.mendola@nih.gov.
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
authors.affiliation: Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Rockville, Md.
authors.forename: Tuija I
authors.initials: TI
authors.lastname: Männistö
authors.affiliation: Division of Epidemiology, Statistics, and Prevention Research (DESPR), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Rockville, Md.
authors.forename: Kira
authors.initials: K
authors.lastname: Leishear
authors.affiliation: Pregnancy and Perinatology Branch, NICHD, Rockville, Md.
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.affiliation: Bioinformatics and Biostatistics Branch, DESPR, NICHD, Rockville, Md.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Rockville, Md.
authors.forename: S Katherine
authors.initials: SK
authors.lastname: Laughon
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007112:Immunity, Maternally-Acquired; D007223:Infant; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology* / Q000401:mortality; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology*; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: CSL; Consortium on Safe Labor; ICD-9; International Classification of Diseases, Ninth Revision; LGA; Large for gestational age; NICU; Neonatal health; Neonatal intensive care unit; OR; Odds ratio; SGA; Small for gestational age; maternal asthma; neonatal jaundice; preterm birth; respiratory distress syndrome; transient tachypnea of the newborn
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