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Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children.
Clin Exp Allergy. 2019 04; 49(4):419-429.CE

Abstract

BACKGROUND

While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma and the role of maternal asthma control in pregnancy on the risk for asthma in the child.

OBJECTIVE

We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3-year-old children and how prenatal and cord blood vitamin D status might affect this risk.

METHODS

Data from 806 women, their partners (biologic fathers of the infants), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrials.gov identification number NCT00920621) were used for this cohort analysis. The parental report of physician-diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for interval-censored event times were used to estimate the main variables of interests and additional covariates on the outcome.

RESULTS

The highest risk was observed among children with both parents being asthmatic relative to non-asthmatic parents (aHR = 2.30, 95% CI: 1.35-3.84), and less so if only the mother was asthmatic (aHR = 1.70, 95% CI: 1.17-2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR = 1.60, 95% CI: 1.02-2.54). Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D ≥ 30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient cord blood vitamin D status at birth (aHR = 0.47, 95% CI: 0.27-0.83).

CONCLUSION AND CLINICAL RELEVANCE

Careful attention to maternal asthma control, monitoring vitamin D status, and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze.

Authors+Show Affiliations

Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, California.Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Washington University, St. Louis, Missouri.Department of Medicine, Pulmonary Center, Boston Medical Center, Boston University, Boston, Massachusetts.Department of Allergy and Research and Evaluation, Kaiser Permanente Southern California Region, San Diego and Pasadena, California.Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.Department of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Partners Center for Personalized Medicine, Partners Health Care, Boston, Massachusetts.Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, New York.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

30461089

Citation

Mirzakhani, Hooman, et al. "Impact of Parental Asthma, Prenatal Maternal Asthma Control, and Vitamin D Status On Risk of Asthma and Recurrent Wheeze in 3-year-old Children." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 49, no. 4, 2019, pp. 419-429.
Mirzakhani H, Carey VJ, Zeiger R, et al. Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children. Clin Exp Allergy. 2019;49(4):419-429.
Mirzakhani, H., Carey, V. J., Zeiger, R., Bacharier, L. B., O'Connor, G. T., Schatz, M. X., Laranjo, N., Weiss, S. T., & Litonjua, A. A. (2019). Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 49(4), 419-429. https://doi.org/10.1111/cea.13320
Mirzakhani H, et al. Impact of Parental Asthma, Prenatal Maternal Asthma Control, and Vitamin D Status On Risk of Asthma and Recurrent Wheeze in 3-year-old Children. Clin Exp Allergy. 2019;49(4):419-429. PubMed PMID: 30461089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3-year-old children. AU - Mirzakhani,Hooman, AU - Carey,Vincent J, AU - Zeiger,Robert, AU - Bacharier,Leonard B, AU - O'Connor,George T, AU - Schatz,Michael X, AU - Laranjo,Nancy, AU - Weiss,Scott T, AU - Litonjua,Augusto A, Y1 - 2019/01/03/ PY - 2018/08/03/received PY - 2018/10/04/revised PY - 2018/11/07/accepted PY - 2018/11/22/pubmed PY - 2020/6/10/medline PY - 2018/11/22/entrez KW - child asthma KW - child sex KW - child wheeze KW - cord blood KW - parental asthma KW - prenatal maternal asthma control KW - prenatal vitamin D SP - 419 EP - 429 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin Exp Allergy VL - 49 IS - 4 N2 - BACKGROUND: While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma and the role of maternal asthma control in pregnancy on the risk for asthma in the child. OBJECTIVE: We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3-year-old children and how prenatal and cord blood vitamin D status might affect this risk. METHODS: Data from 806 women, their partners (biologic fathers of the infants), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrials.gov identification number NCT00920621) were used for this cohort analysis. The parental report of physician-diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for interval-censored event times were used to estimate the main variables of interests and additional covariates on the outcome. RESULTS: The highest risk was observed among children with both parents being asthmatic relative to non-asthmatic parents (aHR = 2.30, 95% CI: 1.35-3.84), and less so if only the mother was asthmatic (aHR = 1.70, 95% CI: 1.17-2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR = 1.60, 95% CI: 1.02-2.54). Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D ≥ 30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient cord blood vitamin D status at birth (aHR = 0.47, 95% CI: 0.27-0.83). CONCLUSION AND CLINICAL RELEVANCE: Careful attention to maternal asthma control, monitoring vitamin D status, and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze. SN - 1365-2222 UR - https://www.unboundmedicine.com/medline/citation/30461089/Impact_of_parental_asthma_prenatal_maternal_asthma_control_and_vitamin_D_status_on_risk_of_asthma_and_recurrent_wheeze_in_3_year_old_children_ L2 - https://doi.org/10.1111/cea.13320 DB - PRIME DP - Unbound Medicine ER -