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Int J Epidemiol. 2015 Feb;44(1):199-208. doi: 10.1093/ije/dyu260. Epub 2015 Jan 27.

Maternal complications in pregnancy and wheezing in early childhood: a pooled analysis of 14 birth cohorts.

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Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Città della Salute e della Scienza University Hospital, CPO Piedmont, Italy, Inserm, Epidemiology of Allergic and Respiratory diseases (EPAR) Department, U707 and UPMC, EPAR UMR-S 707, Medical School Saint-Antoine, Univ6, Sorbonne Universités Paris, France, Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School and EPIUnit - Institute of Public Health, Porto, Portugal, CIBER Epidemiología y Salud Pública (CIBERESP); Subdirección de Salud Pública de Gipuzkoa; Departamento de Sanidad del Gobierno Vasco; Biodonostia, Donostia Ospitalea, Donostia - San Sebastián, Basque Country, Spain, The Generation R Study, Erasmus Medical Center; Department of Epidemiology, Erasmus Medical Center; Department of Pediatrics, Division of Respiratory Medicine and Neonatology, Erasmus Medical Center, Rotterdam, The Netherlands, University of Valencia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP); Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO, Valencia, Spain, Department of Biomedical and Neuromotor Sciences, University of Bologna - Alma Mater Studiorum, Bologna, Italy, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy, Centre for Research in Environmental Epidemiology (CREAL), Barcelona; Hospital del Mar Research Institute (IMIM), Barcelona, Spanish Consortium for Research on Epidemiology (CIBERESP), Barcelona, Spain, MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom, Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands, Department of Medical Microbiology, NUTRIM School for Nutrition, Toxicology and Metabolism



Evidence on the effect of maternal complications in pregnancy on wheezing in offspring is still insufficient.


A pooled analysis was performed on individual participant data from fourteen European birth cohorts to assess the relationship between several maternal pregnancy complications and wheezing symptoms in the offspring. Exposures of interest included hypertension and preeclampsia, diabetes, as well as pre-pregnancy overweight (body mass index between 25 and 29.9) and obesity (body mass index ≥ 30) compared with normal weight (body mass index between 18.5 and 24.9). Outcomes included both ever and recurrent wheezing from birth up to 12-24 months of age. Cohort-specific crude and adjusted risk ratios (RR) were calculated using log-binomial regression models and then pooled using a random effects model.


The study included 85509 subjects. Cohort-specific prevalence of ever wheezing varied from 20.0% to 47.3%, and of recurrent wheezing from 3.0% to 14.3%. Adjusted pooled RR for ever and recurrent wheezing were: 1.02 (95% CI: 0.98-1.06) and 1.20 (95% CI: 0.98-1.47) for hypertensive disorders; 1.09 (95% CI: 1.01-1.18) and 1.23 (95% CI: 1.07-1.43) for preeclampsia; 1.04 (95% CI: 0.97-1.13) and 1.24 (95% CI: 0.86-1.79) for diabetes; 1.08 (95% CI: 1.05-1.11) and 1.19 (95% CI: 1.12-1.26) for overweight; 1.12 (95% CI: 1.08-1.17) and 1.16 (95% CI: 0.97-1.39) for obesity. No heterogeneity was found in RR estimates among the cohorts, except for diabetes and recurrent wheezing (P=0.027).


Preeclampsia, maternal pre-pregnancy overweight and obesity are associated with an increase risk of wheezing in the offspring.


Gestational diabetes; Obesity; Overweight; Pre-eclampsia; Pregnancy induced hypertension

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