School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.
BMJ Paediatr Open. 2021 Jan 5;5(1):e000893. doi: 10.1136/bmjpo-2020-000893. eCollection 2021.
Over the last 20 years, excess maternal pre-pregnancy weight (overweight and obesity) and gestational weight gain have become the most common morbidities in pregnancy. These morbidities may pose a threat to fetal immunological development through associated metabolic dysfunction and inflammation and, as such, may partly explain the concurrent rise of paediatric allergic disease. We will examine the effect of maternal pre-pregnancy weight and gestational weight gain during pregnancy on the incidence of allergic diseases among offspring in Canada's most populous province.
We will conduct a retrospective, population-based cohort study of all singleton live births to residents of Ontario, Canada in 2012-2013 and 2013-2014. The study population will be defined using maternal-newborn records from the provincial birth registry, which captures information on maternal pre-pregnancy weight and gestational weight gain. The cohort will be linked with provincial health administrative databases, allowing for follow-up of neonates through early childhood until 2019 (5-7 years of age). Allergic disease development (asthma, rhinitis, atopic dermatitis and anaphylaxis) will be ascertained using diagnostic codes from healthcare encounters. Potential confounders have been identified a priori through a directed acyclic graph. Cox proportional hazards regression models will be employed to assess the associations between maternal pre-pregnancy weight, gestational weight gain and incident paediatric allergic disease. Several preplanned sensitivity analyses will be conducted, including a probabilistic bias analysis of outcome misclassification.
Ethics approval was obtained from the Research Ethics Board of the Children's Hospital of Eastern Ontario and the ICES Privacy Office. Findings will be disseminated in scientific conference presentations and peer-reviewed publications.
在过去的 20 年中，产妇孕前超重和肥胖以及孕期体重增加已成为妊娠中最常见的疾病。这些疾病可能通过相关的代谢功能障碍和炎症对胎儿的免疫发育构成威胁，因此，它们可能部分解释了儿科过敏疾病的同时发生。我们将研究加拿大人口最多的省份中产妇孕前体重和孕期体重增加对后代过敏疾病发生率的影响。
我们将对 2012-2013 年和 2013-2014 年期间安大略省所有居民的单胎活产进行回顾性、基于人群的队列研究。该研究人群将使用省级出生登记处的母婴记录来定义，该记录可捕获产妇孕前体重和孕期体重增加的信息。该队列将与省级卫生行政数据库相链接，以便通过新生儿期到儿童早期（2019 年，5-7 岁）对新生儿进行随访。通过医疗保健就诊的诊断代码确定过敏疾病（哮喘、鼻炎、特应性皮炎和过敏反应）的发生情况。通过有向无环图事先确定了潜在的混杂因素。将使用 Cox 比例风险回归模型评估产妇孕前体重、孕期体重增加与儿科过敏疾病发病之间的关联。将进行几项预先计划的敏感性分析，包括对结果分类错误的概率偏差分析。
已获得东安大略省儿童医院的伦理审查委员会和 ICES 隐私办公室的伦理批准。研究结果将在科学会议演讲和同行评审出版物中发表。
