The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Pediatr Pulmonol. 2022 Feb;57(2):367-375. doi: 10.1002/ppul.25747. Epub 2021 Nov 12.
Hyperemesis gravidarum, a clinical entity characterized by severe nausea and excess vomiting, might lead to a suboptimal maternal nutritional status during pregnancy and subsequently to adverse respiratory health in the offspring. The role of common vomiting symptoms on offspring's respiratory health is unclear. We examined the associations of maternal daily vomiting during early pregnancy with childhood respiratory outcomes, and potential explaining factors.
This study was embedded in a population-based prospective cohort study from early pregnancy onwards among 4232 mothers and their children. Maternal vomiting during early pregnancy was assessed by a questionnaire. At age 10 years, information on current wheezing and ever asthma was obtained by a questionnaire, and lung function was measured by spirometry at our research center. We used multiple regression analyses to assess the associations of maternal daily vomiting during early pregnancy with childhood respiratory outcomes.
Compared to children from mothers without daily vomiting during early pregnancy, children from mothers with daily vomiting during early pregnancy had a higher forced expiratory flow when 75% of the forced vital capacity (FVC) is exhaled (Z-score difference [95% confidence interval, CI]: 0.13 [0.03, 0.23]), and an increased risk of current wheezing and ever asthma ([odds ratio, OR] [95% CI]: 1.75 [1.10, 2.79] and 1.61 [1.13, 2.31], respectively). These associations were fully explained by sociodemographic factors, but not sex or lifestyle-, infectious-, or growth-related factors. Maternal daily vomiting during early pregnancy was not associated with forced expiratory volume in 1 s (FEV ), FVC, and FEV /FVC.
Only sociodemographic factors explain the associations of maternal daily vomiting during early pregnancy with childhood respiratory outcomes.
妊娠剧吐是一种以严重恶心和过度呕吐为特征的临床病症，可能导致孕妇在妊娠期间营养状况不佳，进而对后代的呼吸健康产生不良影响。常见的呕吐症状对后代呼吸健康的影响尚不清楚。本研究旨在探讨妊娠早期母亲每日呕吐与儿童呼吸结局的关系及其潜在的解释因素。
本研究是一项基于人群的前瞻性队列研究，共纳入了 4232 名母亲及其子女，从妊娠早期开始进行随访。采用问卷评估母亲在妊娠早期的呕吐情况。在儿童 10 岁时，通过问卷调查了解当前喘息和既往哮喘的情况，并在我们的研究中心通过肺功能测定仪测量肺功能。采用多元回归分析评估妊娠早期母亲每日呕吐与儿童呼吸结局的关系。
与妊娠早期母亲无每日呕吐的儿童相比，妊娠早期母亲每日呕吐的儿童用力呼出 75%肺活量时的呼气流速（Z 分数差值[95%置信区间，CI]：0.13 [0.03，0.23]）较高，且当前喘息和既往哮喘的风险增加（比值比[95%CI]：1.75 [1.10，2.79]和 1.61 [1.13，2.31]）。这些关联完全可以用社会人口统计学因素来解释，但不能用性别或生活方式、感染或生长相关因素来解释。妊娠早期母亲每日呕吐与 1 秒用力呼气容积（FEV ）、用力肺活量（FVC）和 FEV/FVC 均无关。
只有社会人口统计学因素可以解释妊娠早期母亲每日呕吐与儿童呼吸结局的关系。
