妊娠期哮喘加重对哮喘妇女的影响：一项基于人群的队列研究
2019/12/09
摘要
妊娠期哮喘发作与母婴健康不良结局之间的关系尚未得到确切的研究。我们的目的是确定哮喘发作对哮喘孕妇的短期和长期代际影响。本项人群队列研究使用了安大略省哮喘监测系统和人群健康管理数据。哮喘孕妇的哮喘发作至少符合下列标准中的一项：5次及以上的内科就诊，或1次急诊就诊，或1次妊娠期哮喘住院。妊娠并发症、不良围产期结局和早期儿童呼吸系统疾病通过第9次和第10次修订的ICD代码确定。队列包括了103 424例患哮喘的单胎妊娠妇女。哮喘孕妇的哮喘发作与子痫前期（或1.30；95%CI 1.12，1.51）、妊娠高血压（或1.17；95%CI 1.02，1.33）的高发率、婴儿低出生体重（或1.14；95%CI 1.00，1.31）的高发率、早产（或1.14；95%CI 1.01，1.29）及先天畸形（或1.21；95%CI 1.05，1.39）相关。妊娠期哮喘发作的妇女所生的儿童在出生后5年内患哮喘（或1.23；95%CI 1.13，1.33）和肺炎（或1.12；95%CI 1.03，1.22）的风险升高。妊娠期哮喘妇女的哮喘发作显示妊娠并发症、不良围产期结局和儿童早期呼吸系统疾病的风险增加，表明适当的哮喘管理可降低不良健康结局的风险。
Effect of asthma exacerbation during pregnancy in women with asthma: A population-based cohort study.
Abdullah K, Zhu J, Gershon A, Dell S, To T.
Abstract
The association between asthma exacerbation (AE) during pregnancy and adverse maternal and child health outcomes have not been appropriately investigated. Our objective was to determine the short- and long-term intergenerational effect of AE in pregnant women with asthma.A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. AE in pregnant women with asthma was defined as at least one of the following criteria: ≥5 physician visits, or 1 emergency department visit, or 1 hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes, and early childhood respiratory disorders were identified using ICD codes 9th and 10th Revisions.The cohort consisted of 103 424 singleton pregnancies in women with asthma. AE in pregnant women with asthma was associated with higher odds of preeclampsia (OR 1.30; 95% CI 1.12, 1.51), and pregnancy induced hypertension (OR 1.17; 95% CI 1.02, 1.33); babies had higher odds of low birth weight (OR 1.14; 95% CI 1.00, 1.31), being pre-term (OR 1.14; 95% CI 1.01, 1.29), and congenital malformations (OR 1.21; 95% CI 1.05, 1.39). Children born to women with AE during pregnancy had elevated risk of asthma (OR 1.23; 95% CI 1.13, 1.33) and pneumonia (OR 1.12; 95% CI 1.03, 1.22) during first 5 years of life.AE during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating appropriate asthma management may reduce the risk of adverse health outcomes.
妊娠期哮喘发作与母婴健康不良结局之间的关系尚未得到确切的研究。我们的目的是确定哮喘发作对哮喘孕妇的短期和长期代际影响。本项人群队列研究使用了安大略省哮喘监测系统和人群健康管理数据。哮喘孕妇的哮喘发作至少符合下列标准中的一项：5次及以上的内科就诊，或1次急诊就诊，或1次妊娠期哮喘住院。妊娠并发症、不良围产期结局和早期儿童呼吸系统疾病通过第9次和第10次修订的ICD代码确定。队列包括了103 424例患哮喘的单胎妊娠妇女。哮喘孕妇的哮喘发作与子痫前期（或1.30；95%CI 1.12，1.51）、妊娠高血压（或1.17；95%CI 1.02，1.33）的高发率、婴儿低出生体重（或1.14；95%CI 1.00，1.31）的高发率、早产（或1.14；95%CI 1.01，1.29）及先天畸形（或1.21；95%CI 1.05，1.39）相关。妊娠期哮喘发作的妇女所生的儿童在出生后5年内患哮喘（或1.23；95%CI 1.13，1.33）和肺炎（或1.12；95%CI 1.03，1.22）的风险升高。妊娠期哮喘妇女的哮喘发作显示妊娠并发症、不良围产期结局和儿童早期呼吸系统疾病的风险增加，表明适当的哮喘管理可降低不良健康结局的风险。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(Eur Respir J. 2019 Nov 26. pii: 1901335. doi: 10.1183/13993003.01335-2019.)
(Eur Respir J. 2019 Nov 26. pii: 1901335. doi: 10.1183/13993003.01335-2019.)
Effect of asthma exacerbation during pregnancy in women with asthma: A population-based cohort study.
Abdullah K, Zhu J, Gershon A, Dell S, To T.
Abstract
The association between asthma exacerbation (AE) during pregnancy and adverse maternal and child health outcomes have not been appropriately investigated. Our objective was to determine the short- and long-term intergenerational effect of AE in pregnant women with asthma.A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. AE in pregnant women with asthma was defined as at least one of the following criteria: ≥5 physician visits, or 1 emergency department visit, or 1 hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes, and early childhood respiratory disorders were identified using ICD codes 9th and 10th Revisions.The cohort consisted of 103 424 singleton pregnancies in women with asthma. AE in pregnant women with asthma was associated with higher odds of preeclampsia (OR 1.30; 95% CI 1.12, 1.51), and pregnancy induced hypertension (OR 1.17; 95% CI 1.02, 1.33); babies had higher odds of low birth weight (OR 1.14; 95% CI 1.00, 1.31), being pre-term (OR 1.14; 95% CI 1.01, 1.29), and congenital malformations (OR 1.21; 95% CI 1.05, 1.39). Children born to women with AE during pregnancy had elevated risk of asthma (OR 1.23; 95% CI 1.13, 1.33) and pneumonia (OR 1.12; 95% CI 1.03, 1.22) during first 5 years of life.AE during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating appropriate asthma management may reduce the risk of adverse health outcomes.
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成人哮喘与情感特征：一项遗传信息研究
