摘要
背景：哮喘母亲所产婴儿在生命早期肺功能会降低，其具体机制尚未明确。妊娠期使用吸入型糖皮质激素与子代肺功能之间的关联尚未得到研究。
目的：探讨妊娠期ICS使用与婴儿肺功能之间的关联。
方法：对妊娠期使用ICS与婴儿4-6周龄时肺功能指标（潮气呼吸流量-容积环及功能残气量）的关联进行多变量回归分析。
结果： 在哮喘母亲所生的婴儿中，与未使用ICS的母亲所生子代相比，母亲在妊娠期使用ICS的子代，其经呼气末肺容积校正的达峰时间比显著改善。与非哮喘母亲所生的对照组婴儿相比，未使用ICS的哮喘母亲所生婴儿的达峰时间比与功能残气量比值较低；然而，在妊娠期使用ICS的哮喘母亲所生婴儿中，该比值与对照组相比无显著差异。
结论：对于母亲在妊娠期使用了ICS的婴儿，母亲哮喘与婴儿肺功能受损之间的关联性减弱。
Association between maternal asthma and impaired infant lung function is diminished by inhaled corticosteroid use in pregnancy.
Gabriela, Martins Costa Gomes; Adam M,
BACKGROUND: Infants of asthmatic mothers have reduced lung function in early life for reasons that remain to be defined. The association between inhaled corticosteroid (ICS) use during pregnancy and lung function in the offspring has not been investigated.
OBJECTIVES: To investigate the association between ICS use during pregnancy and infant lung function.
METHODS: Multivariable regression analysis of infant lung function at 4-6 weeks (tidal breathing flow volume loops and functional residual capacity (FRC)) associated with use of ICS during pregnancy.
RESULTS: Among infants born to asthmatic mothers, the ratio of time to peak tidal expiratory flow to expiratory time (tPTEF:tE), corrected for end-expiratory lung volume (FRC), was improved in offsprings whose mothers used ICS during pregnancy compared with those who did not (n=161 ICS use vs n=25 no ICS use; coefficient 0.06 /mL, 95% CI 0.01 to 0.11, p=0.014). Compared with a control group of infants born to non-asthmatic mothers, there was a lower tPTEF:tE to FRC ratio in infants born to asthmatic mothers without ICS use (n=46 no asthma vs n=25 asthma no ICS use; coefficient -0.08 /mL, 95% CI -0.01 to -0.02, p=0.012) but not in infants born to asthmatic mothers with ICS use (n=46 no asthma vs n=161 asthma ICS use; coefficient -0.02 /mL, 95% CI -0.06 to 0.03, p=0.453).
CONCLUSION: The association between maternal asthma and impaired infant lung function diminished in infants whose mothers used ICS during pregnancy.
背景：哮喘母亲所产婴儿在生命早期肺功能会降低，其具体机制尚未明确。妊娠期使用吸入型糖皮质激素与子代肺功能之间的关联尚未得到研究。
目的：探讨妊娠期ICS使用与婴儿肺功能之间的关联。
方法：对妊娠期使用ICS与婴儿4-6周龄时肺功能指标（潮气呼吸流量-容积环及功能残气量）的关联进行多变量回归分析。
结果： 在哮喘母亲所生的婴儿中，与未使用ICS的母亲所生子代相比，母亲在妊娠期使用ICS的子代，其经呼气末肺容积校正的达峰时间比显著改善。与非哮喘母亲所生的对照组婴儿相比，未使用ICS的哮喘母亲所生婴儿的达峰时间比与功能残气量比值较低；然而，在妊娠期使用ICS的哮喘母亲所生婴儿中，该比值与对照组相比无显著差异。
结论：对于母亲在妊娠期使用了ICS的婴儿，母亲哮喘与婴儿肺功能受损之间的关联性减弱。
（中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校）
（Thorax 2025 Nov 9;(0) DOI:10.1136/thorax-2025-223539 IF: 8.834）
Association between maternal asthma and impaired infant lung function is diminished by inhaled corticosteroid use in pregnancy.
Gabriela, Martins Costa Gomes; Adam M,
BACKGROUND: Infants of asthmatic mothers have reduced lung function in early life for reasons that remain to be defined. The association between inhaled corticosteroid (ICS) use during pregnancy and lung function in the offspring has not been investigated.
OBJECTIVES: To investigate the association between ICS use during pregnancy and infant lung function.
METHODS: Multivariable regression analysis of infant lung function at 4-6 weeks (tidal breathing flow volume loops and functional residual capacity (FRC)) associated with use of ICS during pregnancy.
RESULTS: Among infants born to asthmatic mothers, the ratio of time to peak tidal expiratory flow to expiratory time (tPTEF:tE), corrected for end-expiratory lung volume (FRC), was improved in offsprings whose mothers used ICS during pregnancy compared with those who did not (n=161 ICS use vs n=25 no ICS use; coefficient 0.06 /mL, 95% CI 0.01 to 0.11, p=0.014). Compared with a control group of infants born to non-asthmatic mothers, there was a lower tPTEF:tE to FRC ratio in infants born to asthmatic mothers without ICS use (n=46 no asthma vs n=25 asthma no ICS use; coefficient -0.08 /mL, 95% CI -0.01 to -0.02, p=0.012) but not in infants born to asthmatic mothers with ICS use (n=46 no asthma vs n=161 asthma ICS use; coefficient -0.02 /mL, 95% CI -0.06 to 0.03, p=0.453).
CONCLUSION: The association between maternal asthma and impaired infant lung function diminished in infants whose mothers used ICS during pregnancy.
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