Kemppainen Mari, Kirjavainen Turkka, Helle Emmi, Gissler Mika
Vantaa and Kerava Wellbeing County, Martinlaakso Health Station, Vantaa, Finland.
Helsinki University, Helsinki, Finland.
Acta Obstet Gynecol Scand. 2025 Oct;104(10):1849-1858. doi: 10.1111/aogs.70032. Epub 2025 Aug 3.
Asthma is the most common chronic disease among pregnant women. Some studies have linked maternal asthma to an increased risk of congenital malformations, particularly congenital heart defects (CHDs). Among these, ventricular septal defect (VSD) is the most common, accounting for nearly half of all CHD cases. We investigated the association between maternal asthma and the risk of CHD in offspring. As a sensitivity analysis, we also examined the associations between maternal atopic predisposition, maternal use of asthma medication, and CHD risk.
This retrospective, population-based study utilized a comprehensive birth cohort of all singleton births in Finland between 1996 and 2018. Data were derived by linking four high-coverage national health registers.
The cohort included 1 274 540 eligible mother-child pairs. A total of 106 544 (8.4%) mothers had a diagnosis of asthma or had purchased asthma medication during pregnancy. Of the offspring, 18 772 (1.5%) were diagnosed with a congenital heart defect (CHD), and 8855 (0.7%) had a diagnosis of ventricular septal defect (VSD). Maternal asthma was weakly associated with overall CHD (OR 1.18; 95% CI, 1.12 to 1.24) and with VSD (OR 1.19; 95% CI, 1.10 to 1.27). The association between maternal asthma and CHD was observed in both allergic asthma (OR 1.33; 95% CI, 1.18 to 1.50) and nonallergic asthma (OR 1.27; 95% CI, 1.04 to 1.56). Maternal allergic conditions, such as atopic dermatitis and allergic rhinitis, were also associated with CHD overall (OR 1.13; 95% CI, 1.02 to 1.25) and with VSD (OR 1.20; 95% CI, 1.04 to 1.38).
Maternal asthma and allergic tendency are associated with a modestly increased risk of CHD in offspring, particularly VSD. Nonallergic asthma was also linked to CHD, especially right-sided defects. These findings suggest that maternal allergic inflammation may have teratogenic effects during fetal cardiac development.
哮喘是孕妇中最常见的慢性疾病。一些研究将母亲哮喘与先天性畸形风险增加联系起来，尤其是先天性心脏病（CHD）。其中，室间隔缺损（VSD）最为常见，占所有CHD病例的近一半。我们调查了母亲哮喘与后代患CHD风险之间的关联。作为敏感性分析，我们还研究了母亲的特应性易感性、母亲使用哮喘药物与CHD风险之间的关联。
这项基于人群的回顾性研究利用了1996年至2018年芬兰所有单胎出生的综合出生队列。数据通过链接四个高覆盖率的国家健康登记册获得。
该队列包括1274540对符合条件的母婴对。共有106544名（8.4%）母亲在孕期被诊断为哮喘或购买过哮喘药物。在后代中，18772名（1.5%）被诊断患有先天性心脏病（CHD），8855名（0.7%）被诊断患有室间隔缺损（VSD）。母亲哮喘与总体CHD（OR 1.18；95%CI，1.12至1.24）以及VSD（OR 1.19；95%CI，1.10至1.27）呈弱关联。母亲哮喘与CHD之间的关联在过敏性哮喘（OR 1.33；95%CI，1.18至1.50）和非过敏性哮喘（OR 1.27；95%CI，1.04至1.56）中均有观察到。母亲的过敏性疾病，如特应性皮炎和过敏性鼻炎，也与总体CHD（OR 1.13；95%CI，1.02至1.25）以及VSD（OR 1.20；95%CI，1.04至1.38）有关。
母亲哮喘和过敏倾向与后代患CHD的风险适度增加有关，尤其是VSD。非过敏性哮喘也与CHD有关，尤其是右侧缺陷。这些发现表明母亲的过敏性炎症可能在胎儿心脏发育过程中具有致畸作用。
