Prenatal origins of bronchiolitis: protective effect of optimised asthma management during pregnancy.
OBJECTIVE
Maternal asthma is the most common chronic disease complicating pregnancy and is a risk factor for bronchiolitis in infancy. Recurrent episodes of bronchiolitis are strongly associated with the development of childhood asthma.


METHODS
We conducted a follow-up study of infants born to women with asthma who completed a double-blind randomised controlled trial during pregnancy. In this trial, pregnant women with asthma were assigned to treatment adjustment by an algorithm using clinical symptoms (clinical group) or the fraction of exhaled nitric oxide (FeNO group) and we showed that the FeNO group had significantly lower asthma exacerbation rates in pregnancy.


RESULTS
146 infants attended the 12-month follow-up visit. Infants born to mothers from the FeNO group were significantly less likely to have recurrent episodes of bronchiolitis in the first year of life (OR 0.08, 95% CI 0.01 to 0.62; p=0.016) as compared with the clinical group.


CONCLUSIONS
Optimised management of asthma during pregnancy may reduce recurrent episodes of bronchiolitis in infancy, which could potentially modulate the risk to develop or the severity of emerging childhood asthma.
Experimental & Translational Respiratory Medicine Group, University of Newcastle and Hunter Medical Research Institute, , Newcastle, Austrália.
Joerg
J
Mattes
Vanessa E
VE
Murphy
Heather
H
Powell
Peter G
PG
Gibson
D001249:Asthma / Q000209:etiology / Q000628:therapy*; D001944:Breath Tests; D001988:Bronchiolitis / Q000209:etiology / Q000517:prevention & control*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D012008:Recurrence; D011795:Surveys and Questionnaires
D001993:Bronchodilator Agents; D009569:Nitric Oxide
Asthma