Roff Andrea J, Robinson Joshua L, Hammond Sarah J, Bednarz Jana, Tai Andrew, Clifton Vicki L, Morrison Janna L, Gatford Kathryn L
Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
School of Biomedicine, University of Adelaide, Adelaide, South Australia, Australia.
BJOG. 2025 Jul;132(8):1045-1055. doi: 10.1111/1471-0528.17900. Epub 2024 Jul 8.
BACKGROUND: Clinical and preclinical evidence indicate that in utero maternal asthma exposure increases progeny asthma risk. Whether maternal asthma also increases the risks of progeny allergy is unclear. OBJECTIVES: To synthesise the available evidence on the relationship between in utero exposure to maternal asthma and postnatal asthma, wheezing and allergic diseases (Prospero: CRD42020201538). SEARCH STRATEGY: We systematically searched MEDLINE [PubMed], Embase [Ovid], Web of Science, Informit Health, the Cochrane Library, CINAHL [EBSCOhost], MedNar [Deep Web Technologies], ProQuest Theses and Dissertations, Scopus [Elsevier] and Trove, to the end of 2023. SELECTION CRITERIA: Studies reporting asthma, wheeze and/or allergic disease in progeny of women with and without asthma or with asthma classified by control, exacerbation or severity. DATA COLLECTION AND ANALYSIS: Double screening, selection, data extraction and quality assessment were performed, using Joanna Briggs Institute (JBI) scoring. MAIN RESULTS: Of 134 non-overlapping studies, 127 were included in ≥1 meta-analysis. Maternal asthma ever was associated with greater risks of asthma (65 studies, risk ratio [95% confidence interval] 1.76 [1.57-1.96]), wheeze (35 studies, 1.59 [1.52-1.66]), food allergy (5 studies, 1.32 [1.23-1.40]), allergic rhinitis (7 studies, 1.18 [1.06-1.31]) and allergic dermatitis (14 studies, 1.17 [1.11-1.23]) ever in progeny. Asthma during the pregnancy, more severe, and uncontrolled maternal asthma were each associated with greater risks of progeny asthma. CONCLUSIONS: Children of mothers with asthma are at increased risk for the development of allergic diseases. Whether improved maternal asthma control reduces risks of child allergy as well as asthma requires further investigation.
背景:临床和临床前证据表明,子宫内母体哮喘暴露会增加子代患哮喘的风险。母体哮喘是否也会增加子代患过敏症的风险尚不清楚。 目的:综合现有证据,探讨子宫内暴露于母体哮喘与出生后哮喘、喘息及过敏性疾病之间的关系(国际系统评价注册平台:CRD42020201538)。 检索策略:我们系统检索了MEDLINE[PubMed]、Embase[Ovid]、科学网、Informit Health、Cochrane图书馆、CINAHL[EBSCOhost]、MedNar[Deep Web Technologies]、ProQuest学位论文数据库、Scopus[Elsevier]和Trove,检索截至2023年底的文献。 入选标准:报告有或无哮喘女性子代的哮喘、喘息和/或过敏性疾病,或根据控制情况、加重情况或严重程度对哮喘进行分类的研究。 数据收集与分析:采用乔安娜·布里格斯研究所(JBI)评分法进行双筛查、选择、数据提取和质量评估。 主要结果:在134项非重叠研究中,127项纳入了≥1项荟萃分析。有过母体哮喘病史与子代患哮喘(65项研究,风险比[95%置信区间]1.76[1.57-1.96])、喘息(35项研究,1.59[1.52-1.66])、食物过敏(5项研究,1.32[1.23-1.40])、过敏性鼻炎(7项研究,1.18[1.06-1.31])和过敏性皮炎(14项研究,1.17[1.11-1.23])的风险增加相关。孕期哮喘、更严重的哮喘以及未控制好的母体哮喘均与子代患哮喘的风险增加相关。 结论:哮喘母亲的孩子患过敏性疾病的风险增加。改善母体哮喘控制是否能降低孩子患过敏症和哮喘的风险,还需要进一步研究。
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