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Maternal asthma is associated with reduced lung function in male infants in a combined analysis of the BLT and BILD cohorts
  1. Patricia de Gouveia Belinelo1,2,
  2. Adam M Collison1,2,
  3. Vanessa E Murphy1,2,
  4. Paul D Robinson3,4,
  5. Kathryn Jesson1,
  6. Kate Hardaker3,
  7. Ediane de Queiroz Andrade1,2,
  8. Christopher Oldmeadow2,
  9. Gabriela Martins Costa Gomes1,2,
  10. Peter D Sly5,
  11. Jakob Usemann6,7,
  12. Rhea Appenzeller6,7,
  13. Olga Gorlanova6,7,
  14. Oliver Fuchs6,7,
  15. Philipp Latzin6,7,
  16. Peter G Gibson2,8,9,
  17. Urs Frey6,7,
  18. Joerg Mattes1,2,10
  1. 1Priority Research Centre GrowUpWell, University of Newcastle, Callaghan, New South Wales, Australia
  2. 2Viruses, Infections, Vaccines & Asthma Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
  3. 3Department of Respiratory Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
  4. 4Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia
  5. 5Centre for Children's Health Research, University of Queensland, South Brisbane, Queensland, Australia
  6. 6Department of Pulmonology, University Children’s Hospital (UKBB), Basel, Switzerland
  7. 7Paediatric Respiratory Medicine, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland
  8. 8Priority Research Centre for Healthy Lungs, University of Newcastle, Callaghan, New South Wales, Australia
  9. 9Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
  10. 10Department of Paediatric Respiratory and Sleep Medicine, John Hunter Children’s Hospital, New Lambton Heights, New South Wales, Australia
  1. Correspondence to Professor Joerg Mattes, Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan, New South Wales, Australia; joerg.mattes{at}newcastle.edu.au; Professor Urs Frey, Department of Pulmonology, University Children's Hospital (UKBB), Basel, Switzerland; urs.frey{at}ukbb.ch

Abstract

Rationale Asthma in pregnancy is associated with respiratory diseases in the offspring.

Objective To investigate if maternal asthma is associated with lung function in early life.

Methods Data on lung function measured at 5–6 weeks of age were combined from two large birth cohorts: the Bern Infant Lung Development (BILD) and the Australian Breathing for Life Trial (BLT) birth cohorts conducted at three study sites (Bern, Switzerland; Newcastle and Sydney, Australia). The main outcome variable was time to reach peak tidal expiratory flow as a percentage of total expiratory time(tPTEF:tE%). Bayesian linear hierarchical regression analyses controlling for study site as random effect were performed to estimate the effect of maternal asthma on the main outcome, adjusting for sex, birth order, breast feeding, weight gain and gestational age. In separate adjusted Bayesian models an interaction between maternal asthma and sex was investigated by including an interaction term.

Measurements and main results All 406 BLT infants were born to mothers with asthma in pregnancy, while 193 of the 213 (91%) BILD infants were born to mothers without asthma. A significant interaction between maternal asthma and male sex was negatively associated with tPTEF:tE% (intercept 37.5; estimate: –3.5; 95% credible interval –6.8 to –0.1). Comparing the model posterior probabilities provided decisive evidence in favour of an interaction between maternal asthma and male sex (Bayes factor 33.5).

Conclusions Maternal asthma is associated with lower lung function in male babies, which may have lifelong implications on their lung function trajectories and future risk of wheezing and asthma.

  • asthma
  • paediatric lung disease
  • respiratory measurement

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Footnotes

  • Twitter @DrPLungResearch

  • Contributors JM, UF, PL, PDR and AMC conceived the project and supervised the lung function analysis. PGG, VEM and JM conducted the Breathing for Life Trial (BLT) pregnancy study. JM, PGG, VEM, AMC, PDR, PDS and KH conducted the BLT infant follow-up. PDGB, KJ and EDQA performed the infant lung function. JM supervised the BLT infant follow-up. UF and PL supervised the Bern Infant Lung Development (BILD) study follow-up. UF, PL, RA, OG, OF and JU conducted the BILD infant follow-up. CO and GMCG performed the multivariable Bayesian regression analyses. CO supervised all other statistical analyses and wrote the statistical method section. PDGB and EDQA analysed all lung function data. PDGB and JM wrote a draft manuscript. All authors edited the final version of the manuscript.

  • Funding The study was funded by the National Health and Medical Research Council, Hunter Children’s Research Foundation; Hunter Medical Research Institute, PRC GrowUpWell University of Newcastle; and Charitable Trust, John Hunter Hospital.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The BLT study was approved by the Hunter New England Human Research Ethics Committee of the Hunter New England Local Health District (ref no 12/10/17/3.04). The BILD study was approved by The Bernese Cantonal Ethics Research Committee (Bern, Switzerland).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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