Rejnö Gustaf, Lundholm Cecilia, Saltvedt Sissel, Larsson Kjell, Almqvist Catarina
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Obstetrics and Gynaecology Unit, Södersjukhuset, Stockholm, Sweden.
Clin Exp Allergy. 2021 Jul;51(7):883-891. doi: 10.1111/cea.13864. Epub 2021 Mar 25.
Several maternal conditions can affect fetal growth, and asthma during pregnancy is known to be associated with lower birth weight and shorter gestational age.
In a new Swedish cohort study on maternal asthma exposure and stress during pregnancy (MAESTRO), we have assessed if there is evidence of early fetal growth restriction in asthmatic women or if a growth restriction might come later during pregnancy.
We recruited women from eight antenatal clinics in Stockholm, Sweden. Questionnaires on background factors, asthma status and stress were assessed during pregnancy. The participants were asked to consent to collection of medical records including ultrasound measures during pregnancy, and linkage to national health registers. In women with and without asthma, we studied reduced or increased growth by comparing the second-trimester ultrasound with first-trimester estimation. We defined reduced growth as estimated days below the 10th percentile and increased growth as days above the 90th percentile. At birth, the weight and length of the newborn and the gestational age was compared between women with and without asthma.
We enrolled 1693 participants in early pregnancy and collected data on deliveries and ultrasound scans in 1580 pregnancies, of which 18% of the mothers had asthma. No statistically significant reduced or increased growth between different measurement points were found when women with and without asthma were compared; adjusted odds ratios for reduced growth between first and second trimester 1.11 95% CI (0.63-1.95) and increased growth 1.09 95% CI (0.68-1.77).
In conclusion, we could not find evidence supporting an influence of maternal asthma on early fetal growth in the present cohort: Although the relatively small sample size, which may enhance the risk of a type II error, it is concluded that a potential difference is likely to be very small.
多种母体状况会影响胎儿生长，已知孕期哮喘与低出生体重和较短孕周有关。
在一项关于孕期母亲哮喘暴露与应激的瑞典新队列研究（MAESTRO）中，我们评估了哮喘女性是否有早期胎儿生长受限的证据，或者生长受限是否可能在孕期后期出现。
我们从瑞典斯德哥尔摩的8家产前诊所招募女性。在孕期评估关于背景因素、哮喘状况和应激的问卷。参与者被要求同意收集包括孕期超声测量在内的医疗记录，并与国家健康登记处建立联系。在有哮喘和无哮喘的女性中，我们通过比较孕中期超声与孕早期估计值来研究生长的减少或增加。我们将生长减少定义为估计天数低于第10百分位数，生长增加定义为天数高于第90百分位数。在出生时，比较有哮喘和无哮喘女性的新生儿体重、身长和孕周。
我们在孕早期招募了1693名参与者，并收集了1580例妊娠的分娩和超声扫描数据，其中18%的母亲患有哮喘。比较有哮喘和无哮喘的女性时，在不同测量点未发现生长有统计学显著的减少或增加；孕早期和孕中期生长减少的调整比值比为1.11，95%可信区间（0.63 - 1.95），生长增加的调整比值比为1.09，95%可信区间（0.68 - 1.77）。
总之，在本队列中我们未找到支持母体哮喘对早期胎儿生长有影响的证据：尽管样本量相对较小，这可能增加II类错误的风险，但得出的结论是潜在差异可能非常小。
