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母亲孕期血压和高血压疾病与儿童呼吸道疾病发病风险:生育队列研究。

Maternal blood pressure and hypertensive disorders during pregnancy and childhood respiratory morbidity: the Generation R Study.

机构信息

Dept of Obstetrics and Neonatology, Radboudumc, Nijmegen, The Netherlands.

The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Eur Respir J. 2018 Nov 29;52(5). doi: 10.1183/13993003.00378-2018. Print 2018 Nov.

Abstract

Pre-eclampsia is associated with an increased risk of bronchopulmonary dysplasia, wheezing and asthma in later childhood. Currently, there are no studies available investigating maternal blood pressure measurements during multiple time-points in pregnancy and respiratory outcome measures in the child.We examined the associations of maternal blood pressure and hypertensive disorders with the risk of lower lung function, wheezing and asthma in children aged 10 years. This study among 4894 children was embedded in a population-based prospective cohort study. We used multivariate analyses, taking lifestyle and socioeconomic factors into account.We observed consistent associations per 5 mmHg higher maternal blood pressure in early pregnancy with a lower forced expiratory volume in 1 s/forced vital capacity ratio (z-score -0.03 (95% CI -0.05- -0.01)) and per 5 mmHg higher blood pressure in late pregnancy with a higher risk for current wheezing and current asthma (OR 1.07 (95% CI 1.02-1.12) and 1.06 (95% CI 1.00-1.11), respectively). We found no associations of maternal hypertensive disorders during pregnancy with child lung function, current wheezing or current asthma.Our results suggest that higher blood pressure in pregnant women is associated with lower lung function and increased risks of current wheezing and current asthma in children. The associations may be trimester specific.

摘要

子痫前期与儿童后期支气管肺发育不良、喘息和哮喘的风险增加有关。目前,尚无研究调查妊娠多个时间点的母亲血压测量值和儿童的呼吸结局测量值。我们研究了母亲血压和高血压疾病与儿童 10 岁时较低肺功能、喘息和哮喘风险之间的关联。这项针对 4894 名儿童的研究嵌入在一项基于人群的前瞻性队列研究中。我们使用多元分析,考虑了生活方式和社会经济因素。我们观察到,妊娠早期母亲血压每升高 5mmHg,用力呼气量/用力肺活量比值的 z 分数就会降低 0.03(95%CI -0.05- -0.01),妊娠晚期母亲血压每升高 5mmHg,当前喘息和当前哮喘的风险就会增加 1.07(95%CI 1.02-1.12)和 1.06(95%CI 1.00-1.11)。我们没有发现妊娠期间母亲高血压疾病与儿童肺功能、当前喘息或当前哮喘之间的关联。我们的结果表明,孕妇血压升高与儿童较低的肺功能和当前喘息和当前哮喘的风险增加有关。这些关联可能具有特定的孕期。

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