Abstract
Background Studies on the associations between maternal complications during pregnancy and childhood asthma are exclusively conducted in Western countries. The findings are mixed and may not be translated to other populations. We aimed to investigate the associations among the Chinese population and to determine whether the associations were mediated through preterm birth, cesarean delivery, low birth weight, and not breastfeeding in the first 6 months.
Methods We conducted a retrospective cohort study of 166 772 children in Guangzhou, China. Information on maternal gestational hypertension, gestational diabetes, and gestational anemia during pregnancy was extracted from medical records. Ever diagnosis of asthma in children aged 6–12 years was obtained by questionnaire. Logistic regression models and mediation analyses were used to estimate the adjusted odds ratios (aORs) and 95% confidential intervals (CIs) for childhood asthma.
Results Gestational hypertension, gestational diabetes, and gestational anemia during pregnancy were associated with an increased risk of ever diagnosed childhood asthma; the aOR was 1.48 (95%CI 1.37–1.60), 1.71 (95%CI 1.65–1.78) and 1.34 (95%CI 1.26–1.45), respectively. A stronger association was observed for 2 or 3 gestational complications (aOR=2.02, 95%CI 1.93–2.16) than 1 gestational complication (aOR=1.64, 95%CI 1.52–1.77). The aOR for three gestational complications was 1.35 (95%CI 1.26–1.45), 1.63 (95%CI 1.58–1.70), and 1.32 (95%CI 1.24–1.43), respectively, after controlling for the mediators, including preterm birth, cesarean delivery, low birth weight, and not breastfeeding in the first 6 months.
Conclusions Gestational hypertension, diabetes, and anemia during pregnancy were associated with childhood asthma, and the associations were partially explained by the mediation effects.
Footnotes
This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.
Conflict of interest: The author Jie Tang is a member of the Editorial Board for the journal. However, the paper was handled by the other Editor and has undergone rigorous peer review process. Dr Jie Tang was not involved in the journal's review of, or decisions related to, this manuscript. Other authors declare that they have no competing interests.
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- Received October 20, 2022.
- Accepted December 27, 2022.
- Copyright ©The authors 2023
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