Maternal Asthma, Preterm Birth, and Risk of Bronchopulmonary Dysplasia

详细信息    查看全文

• 作者：Susan Gage ; MD¹ ; ^{sgage@stanford.edu" class="auth_mail" title="E-mail the corresponding author} ; Peiyi Kan ; MS¹ ; Henry C. Lee ; MD¹ ; ² ; Jeffrey B. Gould ; MD¹ ; ² ; ³ ; David K. Stevenson ; MD¹ ; Gary M. Shaw ; DrPH¹ ; Hugh M. O'Brodovich ; MD¹
• 关键词：BMI ; Body mass index ; BPD ; Bronchopulmonary dysplasia ; BW ; Birth weight ; CPQCC ; California Perinatal Quality Care Collaborative ; GA ; Gestational age ; ICD-9 ; International Classification of Diseases ; Ninth Revision ; ID ; Identification number ; NICU ; Neonatal intensive care unit ; OSHPD ; California Office of Statewide Health Planning and Development ; RDS ; Respiratory distress syndrome
• 刊名：The Journal of Pediatrics
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：167
• 期：4
• 页码：875-880.e1
• 全文大小：334 K

文摘

To study the relationship between maternal asthma and the development of bronchopulmonary dysplasia (BPD).

Study design

Using a large population-based California cohort, we investigated associations between maternal asthma and preterm birth subtype, as well as maternal asthma and BPD. We used data from 2007-2010 maternal delivery discharge records of 2鈥?09鈥?11 pregnancies and International Classification of Diseases, Ninth Revision codes. Preterm birth was defined as <37 weeks gestational age (GA), with subgroups of <28 weeks, 28-32 weeks, and 33-37 weeks GA, as well as preterm subtype, defined as spontaneous, medically indicated, or unknown. Linkage between the 2 California-wide datasets yielded 21鈥?44 singleton preterm infants linked to their mother's records, allowing estimation of the risk of BPD in mothers with asthma and those without asthma.

Results

Maternal asthma was associated with increased odds (OR, 1.42; 95% CI, 1.38-1.46) of preterm birth at <37 weeks GA, with the greatest risk for 28-32 GA (aOR, 1.60; 95% CI, 1.47-1.74). Among 21鈥?44 preterm infants, we did not observe an elevated risk for BPD in infants born to mothers with asthma (aOR, 1.03; 95% CI, 0.9-1.2). Stratification by maternal treatment with antenatal steroids revealed increased odds of BPD in infants whose mothers had asthma but did not receive antenatal steroids (aOR, 1.54; 95% CI, 1.15-2.06), but not in infants whose mothers had asthma and were treated with antenatal steroids (aOR, 0.85; 95% CI, 0.67-1.07).

Conclusion

Asthma in mothers who did not receive antenatal steroid treatment is associated with an increased risk of BPD in their preterm infants.