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Gestational hypertension and childhood atopy: a Millennium Cohort Study analysis.
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Henderson, Ian and Quenby, Siobhan (2021) Gestational hypertension and childhood atopy: a Millennium Cohort Study analysis. European Journal of Pediatrics, 180 . pp. 2419-2427. doi:10.1007/s00431-021-04012-3 ISSN 1432-1076.
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WRAP-gestational-hypertension-childhood-atopy-Quenby-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (352Kb) | Preview |
Official URL: http://dx.doi.org/10.1007/s00431-021-04012-3
Abstract
Gestational hypertension may confer risk of atopic disease in offspring through a direct biological mechanism, but another possibility is that risk is mediated through complications of pregnancy. To explore these associations, we conducted an analysis of a nationally representative birth cohort based in the UK involving children born 2000-2002. We included 12,450 mother-child pairs. We used logistic regression to estimate the association between hypertensive disease and asthma, hay fever, or eczema by age 5, and parentally reported early wheeze and severe wheeze. Mediation by gestation at delivery and caesarean delivery was explored using causal mediation analysis. Odds ratios (95% CI) for gestational hypertension and childhood asthma, hay fever, and eczema were 1.32 (1.09, 1.59), 1.22 (0.97, 1.55), and 1.12 (0.96, 1.32) respectively, adjusted for confounding. The population attributable fractions were 2.4% (1.0-3.8%), 0.9% (-0.3% to 2.1%), and 1.8% (0.0-3.7%), respectively. Accounting for mediation by gestational age and caesarean delivery, odds ratios (95% CI) for the potential direct effects of gestational hypertension were 1.21 (0.97, 1.50), 1.17 (0.91, 1.49), and 1.11 (0.94, 1.31) for the same.Conclusion: Gestational hypertension was weakly positively associated with asthma and this was partly mediated by earlier delivery. Only a small proportion of early childhood asthma was attributable to gestational hypertensive disease in this representative UK-based birth cohort. What is known: • Gestational hypertension has been shown to be an inconsistent risk factor for the atopic diseases. • The in utero immune environment may modify the risk of atopy in offspring; alternatively, complications of pregnancy including caesarean delivery and prematurity may explain an association between hypertensive disease and atopy. What is new: • Self-reported gestational hypertension was a weak risk factor for asthma and wheeze in the Millennium Cohort Study. • Part of the association between gestational hypertensive disease and asthma was explained by earlier delivery.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RL Dermatology | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | ||||||||
| Library of Congress Subject Headings (LCSH): | Atopic dermatitis, Hypertension in pregnancy, Allergy -- Genetic aspects, Asthma -- Genetic aspects | ||||||||
| Journal or Publication Title: | European Journal of Pediatrics | ||||||||
| Publisher: | Springer | ||||||||
| ISSN: | 1432-1076 | ||||||||
| Official Date: | August 2021 | ||||||||
| Dates: |
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| Volume: | 180 | ||||||||
| Page Range: | pp. 2419-2427 | ||||||||
| DOI: | 10.1007/s00431-021-04012-3 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Date of first compliant deposit: | 22 June 2021 | ||||||||
| Date of first compliant Open Access: | 22 June 2021 |
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