title: Hypertensive disorders of pregnancy, respiratory outcomes and atopy in childhood.
abstract: Few epidemiological studies have investigated the role of hypertensive disorders of pregnancy in the aetiology of childhood respiratory and atopic outcomes.In the Avon Longitudinal Study of Parents and Children we examined associations of maternal gestational hypertension, hypertension before pregnancy and pre-eclampsia with wheezing at 18 months, wheezing and asthma at 7 years and lung function at 8-9 years, after controlling for potential confounders (n=5322-8734, depending on outcome).Gestational hypertension was not associated with any of the outcomes. There was weak evidence for a positive association between pre-eclampsia and early wheezing (adjusted OR 1.31, 95% CI 0.94-1.82, compared to normotensive pregnancies) and for negative associations between pre-eclampsia and forced expiratory volume in 1 s (adjusted mean difference in sd score -0.14, 95% CI -0.33-0.06) and maximal mid-expiratory flow (-0.15, 95% CI -0.34-0.04). Hypertension before pregnancy was positively associated with wheezing (OR 1.63, 95% CI 1.16-2.31) and asthma (OR 1.34, 95% CI 1.00-1.79).Gestational hypertension is unlikely to be a risk factor for childhood respiratory disorders; hypertension before pregnancy may be a risk factor for childhood wheezing and asthma, but this finding needs replication. Larger studies are needed to confirm whether pre-eclampsia is associated with impaired childhood lung function.
authors.affiliation: Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, UK s.shaheen@qmul.ac.uk.
authors.forename: Seif O
authors.initials: SO
authors.lastname: Shaheen
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
authors.forename: Corrie
authors.initials: C
authors.lastname: Macdonald-Wallis
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
authors.forename: Debbie A
authors.initials: DA
authors.lastname: Lawlor
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: A John
authors.initials: AJ
authors.lastname: Henderson
mesh_terms: D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D006973:Hypertension / Q000453:epidemiology*; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012135:Respiratory Sounds / Q000503:physiopathology; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology