Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
BMJ Open. 2021 Sep 2;11(9):e046769. doi: 10.1136/bmjopen-2020-046769.
The association between hypertensive disorders in pregnancy (HDP) and an increased risk of asthma in offspring remains controversial. No systematic review of this topic has been performed. The aim of this systematic review was to summarise the available evidence regarding the association between HDP and the risk of asthma in offspring.
Systematic review and meta-analysis.
On the basis of a prepared protocol, a systematic search of PubMed, EMBASE, the Cochrane Library and Web of Science was performed using a detailed search strategy from the database inception to 17 January 2020. Cohort, case-control and cross-sectional studies published in English reporting the diagnoses of maternal HDP and asthma in offspring were included. The Meta-analysis of Observational Studies in Epidemiology guidelines were followed throughout the study. The estimated pooled ORs of HDP and asthma in offspring were calculated from the studies, and the meta-analysis was performed using random-effects models.
Ten cohort studies involving a total of 6 270 430 participants were included. According to the Newcastle-Ottawa Scale, the overall methodological quality was good since 8 studies were of high quality and 2 studies were of moderate quality. After controlling for potential confounders, HDP was associated with a possible increased risk of asthma in offspring, with a pooled adjusted OR (aOR) of 1.19 (95% CI 1.12 to 1.26). The subgroup analyses according to HDP subgroups, sibling design, study quality, study location, offspring ages, singleton status, exposure assessment, outcome assessment and adjusted factors showed similar results.
Exposure to HDP may be associated with an increased risk of asthma in offspring. Further research is needed to verify the results and determine whether the observed relationship is causal.
CRD42020148250.
妊娠高血压疾病（HDP）与后代哮喘风险增加之间的关联仍存在争议。尚未对此主题进行系统评价。本系统评价的目的是总结现有关于 HDP 与后代哮喘风险之间关联的证据。
系统评价和荟萃分析。
根据准备好的方案，使用详细的搜索策略从数据库建立到 2020 年 1 月 17 日，对 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 进行了系统搜索。纳入了以英语发表的报告母亲 HDP 和后代哮喘诊断的队列研究、病例对照研究和横断面研究。研究过程中遵循了观察性研究荟萃分析的流行病学指南。从研究中计算了 HDP 和后代哮喘的估计合并 OR，并使用随机效应模型进行了荟萃分析。
共纳入了 10 项队列研究，总计 6270430 名参与者。根据纽卡斯尔-渥太华量表，由于 8 项研究质量较高，2 项研究质量中等，整体方法学质量较好。在控制潜在混杂因素后，HDP 与后代哮喘的发生风险可能增加相关，合并调整后的 OR（aOR）为 1.19（95%CI 1.12 至 1.26）。根据 HDP 亚组、同胞设计、研究质量、研究地点、后代年龄、单胎状态、暴露评估、结局评估和调整因素进行的亚组分析得出了相似的结果。
暴露于 HDP 可能与后代哮喘风险增加有关。需要进一步的研究来验证结果并确定观察到的关系是否具有因果关系。
PROSPERO 注册号：CRD42020148250。
