Murphy Vanessa E, Mattes Joerg, Powell Heather, Baines Katherine J, Gibson Peter G
Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia.
Pediatr Allergy Immunol. 2014 Mar;25(2):151-8. doi: 10.1111/pai.12156. Epub 2013 Dec 13.
There are few studies investigating the relationship between respiratory viral infection in pregnancy and asthma in the offspring, and none among mothers with asthma. Infants of mothers with asthma are more likely to wheeze and have a higher risk of developing asthma than infants of non-asthmatic mothers.
A prospective cohort study of viral infection in pregnancy was conducted between 2007 and 2009, and a subgroup of infants of mothers with asthma was followed up at 6 and 12 months of age. During common colds, nasal and throat swabs were collected from mothers and respiratory viruses detected by polymerase chain reaction. Respiratory health of infants was assessed by parent-completed questionnaire.
Twelve-month-old infants whose mothers had confirmed viral infections in pregnancy (n = 26) reported more frequent wheeze (40% had 4-12 wheeze attacks compared with 0%), sleep disturbed by wheeze (1 night per week or more in 60% vs. 11%), beta agonist treatment for wheeze (27% vs. 0%), prolonged colds (2 wk or longer 31% vs. 0%), more eczema (40% vs. 6.3%), and parent-perceived asthma (32% vs. 0%), compared with infants whose mothers had common colds without laboratory-confirmed viral infection (n = 16).
This study demonstrates a relationship between maternal respiratory viral infection in pregnancy and wheezing illness in infants of mothers with asthma. Viral infections are the most common cause of asthma exacerbations in pregnancy, and infants of asthmatic mothers are at increased risk of asthma themselves. Further research is needed to elucidate the mechanisms involved.
很少有研究调查孕期呼吸道病毒感染与后代哮喘之间的关系，在患有哮喘的母亲中尚未有此类研究。与非哮喘母亲的婴儿相比，哮喘母亲的婴儿更易出现喘息，且患哮喘的风险更高。
2007年至2009年期间对孕期病毒感染进行了一项前瞻性队列研究，并对哮喘母亲的婴儿亚组在6个月和12个月大时进行了随访。在普通感冒期间，采集母亲的鼻拭子和咽拭子，通过聚合酶链反应检测呼吸道病毒。通过家长填写的问卷评估婴儿的呼吸健康状况。
与母亲患普通感冒但未经过实验室确诊病毒感染的婴儿（n = 16）相比，母亲在孕期确诊有病毒感染的12个月大婴儿（n = 26）报告喘息更频繁（40%有4 - 12次喘息发作，而另一组为0%）、喘息导致睡眠受干扰（60%每周有1晚或更多，另一组为11%）、因喘息接受β受体激动剂治疗（27% vs. 0%）、感冒持续时间延长（2周或更长时间，31% vs. 0%）、患湿疹更多（40% vs. 6.3%）以及家长认为有哮喘（32% vs. 0%）。
本研究证明了孕期母亲呼吸道病毒感染与哮喘母亲的婴儿喘息性疾病之间的关系。病毒感染是孕期哮喘加重的最常见原因，哮喘母亲的婴儿自身患哮喘的风险增加。需要进一步研究以阐明其中涉及的机制。
