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Bakoyan Z, Cao Y, Hansson SR, Karlsson JP, Lodefalk M. Childhood atopic disorders in relation to placental changes-A systematic review and meta-analysis. Pediatr Allergy Immunol 2024; 35:e14141. [PMID: 38773752 DOI: 10.1111/pai.14141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024]
Abstract
Fetal programming may arise from prenatal exposure and increase the risk of diseases later in life, potentially mediated by the placenta. The objective of this systematic review was to summarize and critically evaluate publications describing associations between human placental changes and risk of atopic disorders during childhood. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. The inclusion criteria were original research articles or case reports written in English describing a human placental change in relation to disease occurring in offspring during childhood. The MEDLINE and EMBASE databases were searched for eligible studies. Risk of bias (RoB) was assessed using the ROBINS-I tool. The results were pooled both in a narrative way and by a meta-analysis. Nineteen studies were included (n = 12,997 participants). All studies had an overall serious RoB, and publication bias could not be completely ruled out. However, five studies showed that histological chorioamnionitis in preterm-born children was associated with asthma-related problems (pooled odds ratio = 3.25 (95% confidence interval = 2.22-4.75)). In term-born children, a large placenta (≥750 g) increased the risk of being prescribed anti-asthma medications during the first year of life. Placental histone acetylation, DNA methylation, and gene expression differences were found to be associated with different atopic disorders in term-born children. There is some evidence supporting the idea that the placenta can mediate an increased risk of atopic disorders in children. However, further studies are needed to validate the findings, properly control for confounders, and examine potential mechanisms.
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Affiliation(s)
- Zaki Bakoyan
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Stefan R Hansson
- Department of Obstetrics and Gynecology, Institute of Clinical Science Lund, Lund University, Lund, Sweden
| | | | - Maria Lodefalk
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Pediatrics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Suaini NHA, Van Bever H, Tham EH. Growing Up in Singapore with allergies - Lessons learnt from the GUSTO & S-PRESTO cohorts. Allergol Int 2024; 73:13-19. [PMID: 37805278 DOI: 10.1016/j.alit.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 08/31/2023] [Indexed: 10/09/2023] Open
Abstract
Healthcare systems across the world face major challenges due to allergic diseases, known to affect people of all ages. In Singapore, two prominent cohort studies, Growing Up in Singapore Towards healthy Outcomes (GUSTO) and the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO), have made notable advancements to our knowledge and understanding of allergic diseases. These cohorts, which comprised of healthy mother-infant dyads recruited from the healthy Singapore population, have shed light on the complex connections between factors influencing health in early life, preconception and pregnancy, on the pathogenesis of allergic disorders in offspring. GUSTO highlighted significant risk factors in antenatal and early life, such as maternal diet, health and lifestyle choices, as well as infant environmental influences, that contributed to the risk of allergic diseases in the Asian Singaporean population. It also identified differential patterns of allergic disease in comparison to other populations, particularly the role of the microbiome in predicting atopic outcomes. Meanwhile, S-PRESTO further explores the long-term maternal and child outcomes associated with preconception health. Findings seem to suggest that prevention of offspring allergic conditions can be achieved through optimizing maternal health and lifestyle choices before conception. Both studies underscore the significance of early life interventions, preconception health, and personalized approaches to effectively manage and prevent allergies. By leveraging the insights and promising findings from GUSTO and S-PRESTO, future work can drive development of preventative strategies and personalized interventions to reduce burden of allergic diseases in the Singapore population.
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Affiliation(s)
- Noor H A Suaini
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Hugo Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore
| | - Elizabeth Huiwen Tham
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), Singapore; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore; Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore; Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore.
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Hsu MC, Lin CH, Lin MC. Maternal gestational diabetes mellitus and risk of allergic diseases in offspring. Pediatr Neonatol 2023:S1875-9572(23)00216-4. [PMID: 38052685 DOI: 10.1016/j.pedneo.2023.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/21/2023] [Accepted: 06/07/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus has been linked to inflammation, immune dysregulation in offspring, and changes in the microbiota. It may have long-term implications for the health of children. The aim of this study was to determine if gestational diabetes mellitus increases the risk of allergic diseases in offspring. METHODS The data source was the National Health Insurance Research Database (NHIRD) of Taiwan. The pairing of mothers and children was established by connecting the NHIRD with the Taiwan Maternal and Child Health Database. First-time pregnant mothers between 2004 and 2019 were enrolled. The GDM group consisted of 22,741 cases. The control group was selected from individuals without GDM matched by maternal age, neonatal gender, and neonatal birthdate at a ratio of 1-4. The primary endpoint was the incidence of childhood allergic diseases, such as asthma, allergic rhinitis, atopic dermatitis, and urticaria. The secondary endpoint was the risk associated with the development of allergic diseases in offspring, considering the presence or absence of insulin therapy. RESULTS The development of allergic rhinitis, atopic dermatitis, and urticaria were found to be significantly associated with GDM. However, no significant association was observed between GDM and asthma. GDM control without insulin was associated with an increased risk of developing allergic rhinitis, urticaria, and atopic dermatitis. However, in the group receiving insulin treatment, there was no significant elevation in the risk of any allergic diseases. CONCLUSION GDM may elevate the risk of certain atopic diseases in offspring, such as allergic rhinitis, atopic dermatitis, and urticaria.
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Affiliation(s)
- Min-Che Hsu
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Food and Nutrition, Providence University, Taichung, Taiwan; Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chien-Heng Lin
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Chih Lin
- Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Food and Nutrition, Providence University, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
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Huang X, Huang Z, Zhang J, Jiang Y. Maternal gestational diabetes mellitus and the childhood asthma in offspring: a meta-analysis. Ital J Pediatr 2023; 49:139. [PMID: 37840137 PMCID: PMC10577943 DOI: 10.1186/s13052-023-01532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Maternal diabetes might be related to a high risk of allergic disease in offspring. However, it remains unknown if maternal gestational diabetes mellitus (GDM) is also associated with a high incidence of childhood asthma in offspring. A systematic review and meta-analysis was performed to investigate the above association. METHODS Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library, and Web of Science. A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. The Newcastle-Ottawa Scale was used for study quality evaluation. Subgroup analyses were performed to evaluate the potential influences of study characteristics on the outcome. RESULTS Ten datasets from seven moderate to high quality cohort studies, involving 523,047 mother-child pairs were included in the meta-analysis. Overall, maternal GDM was associated with a higher risk of childhood asthma in offspring (risk ratio [RR]: 1.22, 95% confidence interval [CI]: 1.07 to 1.39, p = 0.003; I2 = 30%). Subgroup analyses showed that the association was not significantly affected by study design, validation methods for GDM, or diagnostic strategy for asthma (p for subgroup analyses all > 0.05). The association between maternal GDM and asthma in offspring was more remarkable after adjusting maternal body mass index in early pregnancy (RR: 1.50 versus 1.06, p < 0.001), but significantly weakened after adjusting hypertensive disorders during pregnancy (RR: 1.08 versus 1.50, p = 0.001). CONCLUSIONS Maternal GDM may be associated with an increased incidence of childhood asthma in offspring.
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Affiliation(s)
- Xufeng Huang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China.
| | - Zhengguo Huang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
| | - Jing Zhang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
| | - You Jiang
- Department of Pediatrics, Fuyang First People's Hospital, No. 429 Beihuan Road, Fuyang District, Hangzhou, 311400, China
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Chen YJ, Lin LZ, Liu ZY, Wang X, Karatela S, Wang YX, Peng SS, Jiang BB, Li XX, Liu N, Jing J, Cai L. Association between maternal gestational diabetes and allergic diseases in offspring: a birth cohort study. World J Pediatr 2023; 19:972-982. [PMID: 37029331 DOI: 10.1007/s12519-023-00710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/22/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Previous studies have linked gestational diabetes (GDM) with allergies in offspring. However, the effect of specific glucose metabolism metrics was not well characterized, and the role of polyunsaturated fatty acids (PUFAs), a modifier of metabolism and the immune system, was understudied. We aimed to investigate the association between maternal GDM and allergic diseases in children and the interaction between glucose metabolism and PUFAs on allergic outcomes. METHODS This prospective cohort study included 706 mother-child dyads from Guangzhou, China. Maternal GDM was diagnosed via a 75-g oral glucose tolerance test (OGTT), and dietary PUFAs were assessed using a validated food frequency questionnaire. Allergic disease diagnoses and the age of onset were obtained from medical records of children within three years old. RESULTS Approximately 19.4% of women had GDM, and 51.3% of children had any allergic diseases. GDM was positively associated with any allergic diseases (hazard ratio [HR] 1.40; 95% confidence interval (CI) 1.05-1.88) and eczema (HR 1.44; 95% CI 1.02-1.97). A unit increase in OGTT after two hours (OGTT-2 h) glucose was associated with an 11% (95% CI 2%-21%) higher risk of any allergic diseases and a 17% (95% CI 1-36%) higher risk of food allergy. The positive associations between OGTT-2 h glucose and any allergic diseases were strengthened with decreased dietary a-linolenic acid (ALA) and increased n-6 PUFAs, linoleic acid (LA), LA/ALA ratio, and n-6/n-3 PUFA ratio. CONCLUSIONS Maternal GDM was adversely associated with early-life allergic diseases, especially eczema. We were the first to identify OGTT-2 h glucose to be more sensitive in inducing allergy risk and that dietary PUFAs might modify the associations.
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Affiliation(s)
- Yu-Jing Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Li-Zi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Zhao-Yan Liu
- Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Xin Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, People's Republic of China
| | - Shamshad Karatela
- Faculty of Health and Behavioural Sciences, Pharmacy Australia Centre of Excellence, University of Queensland, Woolloongabba, QLD, Australia
- Institute of Tropical Health and Medicine (AITHM), James Cook University, Townsville, QLD, Australia
| | - Yu-Xuan Wang
- Global Health Research Center, Duke Kunshan University, Kunshan, People's Republic of China
| | - Shan-Shan Peng
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Bi-Bo Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Xiao-Xu Li
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Nan Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, 510080, Guangdong Province, People's Republic of China.
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, People's Republic of China.
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Choa ZX, Yap GC, Du R, Loo EXL, Goh AEN, Teoh OH, Van Bever HPS, Shek LPC, Lee BW, Tan KH, Godfrey KM, Eriksson JG, Chong YS, Chan SY, Tham EH. Gestational onset diabetes mellitus does not impact infant allergic outcomes. Pediatr Allergy Immunol 2023; 34:e13920. [PMID: 36825746 DOI: 10.1111/pai.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Zhao Xiang Choa
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Gaik Chin Yap
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Ruochen Du
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Evelyn Xiu Ling Loo
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Anne Eng Neo Goh
- Allergy Service, Department of Paediatrics, KK Women's and Children's Hospital (KKH), Singapore City, Singapore
| | - Oon Hoe Teoh
- Respiratory Service, Department of Paediatrics, KK Women's and Children's Hospital (KKH), Singapore City, Singapore
| | - Hugo P S Van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore City, Singapore
| | - Lynette Pei-Chi Shek
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore City, Singapore
| | - Bee Wah Lee
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital (KKH), Singapore City, Singapore
| | - Keith M Godfrey
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- Medical Research Council Lifecourse Epidemiology Centre, Southampton, UK
| | - Johan Gunnar Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Folkhälsan Research Center, Helsinki, Finland
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Shiao Yng Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
| | - Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore City, Singapore
- Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore City, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System (NUHS), Singapore City, Singapore
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Dumas O, Arroyo AC, Faridi MK, James K, Hsu S, Powe C, Camargo CA. Cohort Study of Maternal Gestational Weight Gain, Gestational Diabetes, and Childhood Asthma. Nutrients 2022; 14:nu14235188. [PMID: 36501218 PMCID: PMC9741125 DOI: 10.3390/nu14235188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022] Open
Abstract
Data on the association of maternal gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with childhood asthma are limited and inconsistent. We aimed to investigate these associations in a U.S. pre-birth cohort. Analyses included 16,351 mother-child pairs enrolled in the Massachusetts General Hospital Maternal-Child Cohort (1998-2010). Data were obtained by linking electronic health records for prenatal visits/delivery to determine BMI, GWG, and GDM (National Diabetes Data Group criteria) and to determine asthma incidence and allergies (atopic dermatitis or allergic rhinitis) for children. The associations of prenatal exposures with asthma were evaluated using logistic regression adjusted for maternal characteristics. A total of 2306 children (14%) developed asthma by age 5 years. Overall, no association was found between GWG and asthma. GDM was positively associated with offspring asthma (OR 1.46, 95% CI 1.14-1.88). Associations between GDM and asthma were observed only among mothers with early pregnancy BMI between 20 and 24.9 kg/m2 (OR 2.31, CI 1.46-3.65, p-interaction 0.02). We report novel findings on the impact of prenatal exposures on asthma, including increased risk among mothers with GDM, particularly those with a normal BMI. These findings support the strengthening of interventions targeted toward a healthier pregnancy, which may also be helpful for childhood asthma prevention.
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Affiliation(s)
- Orianne Dumas
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d’Épidémiologie Respiratoire Intégrative, CESP, 94807 Villejuif, France
- Correspondence:
| | - Anna Chen Arroyo
- Division of Pulmonary, Allergy & Critical Care Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Mohammad Kamal Faridi
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Kaitlyn James
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sarah Hsu
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Camille Powe
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA 02114, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA
- Broad Institute, Cambridge, MA 02142, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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Abstract
PURPOSE OF REVIEW To review recent evidence linking maternal body mass index and gestational diabetes mellitus (GDM) with offspring health outcomes. RECENT FINDINGS It is now established that the rising prevalences of maternal obesity and GDM are both making substantial contributions to the growing burden of childhood obesity and associated disorders. Strengthening evidence also links maternal obesity with increased offspring risks of cardiovascular disease, nonalcoholic fatty liver disease, lower respiratory tract infections during infancy, wheezing illnesses, asthma and attention deficit hyperactivity disorder during childhood, and with higher risks of psychiatric disorders and colorectal cancer in adulthood. GDM has been associated with increased offspring risks of cardiovascular disease, childhood wheeze/asthma (but not allergic sensitization), and with high refractive error, attention deficit hyperactivity and psychiatric disorders from childhood onwards. SUMMARY The long-term consequences of maternal obesity and GDM for the offspring in childhood and later adult life present major challenges for public health across the life course and for future generations. Tackling these challenges requires a systems-based approach to support achieving a healthy weight in young people prior to conception, alongside new insights into population based preventive measures against gestational diabetes.
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Affiliation(s)
- Kathryn V Dalrymple
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- Department of Women and Children's Health, School of Life Course and Population Sciences, King's College London, London
| | - Sarah El-Heis
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
| | - Keith M Godfrey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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9
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Bovbjerg ML. Current Resources for Evidence-Based Practice, November 2021. J Obstet Gynecol Neonatal Nurs 2021; 50:789-800. [PMID: 34653377 DOI: 10.1016/j.jogn.2021.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
An extensive review of new resources to support the provision of evidence-based care for women and infants. The current column includes a discussion of autonomy and respect in maternity care and commentaries on reviews focused on whether to induce women who present with mild preeclampsia in the late preterm period and the extent to which urinary incontinence symptoms prevent women from participating in exercise. It also includes a brief update about the USPSTF guidelines on screening for gestational diabetes.
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10
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Pagano F, Conti MG, Boscarino G, Pannucci C, Dito L, Regoli D, Di Chiara M, Battaglia G, Prota R, Cinicola B, Zicari AM, Aloi M, Oliva S, Terrin G. Atopic Manifestations in Children Born Preterm: A Long-Term Observational Study. CHILDREN-BASEL 2021; 8:children8100843. [PMID: 34682108 PMCID: PMC8534898 DOI: 10.3390/children8100843] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 08/24/2021] [Accepted: 09/22/2021] [Indexed: 01/01/2023]
Abstract
(1) Background: Preterm birth exposes the infant to the known risk factors for atopic diseases. We aimed to study the neonatal risk factors and to describe the clinical manifestations of atopy, including the march of symptoms, in a cohort of preschool children born preterm. (2) Methods: We enrolled neonates with gestational age < 32 weeks or birth weight < 1500 g. We classified patients in cases and controls according to the presence of at least one atopic manifestation. (3) Results: We observed 72 cases and 93 controls. Multivariate models showed that the administration of more than one cycle of antibiotics (B 0.902, p = 0.026) and gestational diabetes (B 1.207, p = 0.035) influence the risk of atopy in babies born preterm. In addition, risk of atopic dermatitis was influenced by gestational age < 29 weeks (B -1.710, p = 0.025) and gestational diabetes (B 1.275, p = 0.027). The risk of wheeze was associated with familiarity for asthma (B 1.392, p = 0.022) and the administration of more than one cycle of antibiotics (B 0.969, p = 0.025). We observed a significant reduction in the rate of atopic manifestation after 2 years of life (33.9% vs. 23.8%, p < 0.05). (4) Conclusions: Modifiable (gestational diabetes, antibiotics use) and unmodifiable (familiarity for asthma) conditions influence the risk of atopy in babies born preterm. Extreme prematurity reduces the risk of atopic dermatitis. Preterm babies showed a peculiar atopic march.
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Affiliation(s)
- Federica Pagano
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Maria Giulia Conti
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
- Department of Molecular Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Boscarino
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Chiara Pannucci
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Lucia Dito
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Daniela Regoli
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Maria Di Chiara
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Giuseppe Battaglia
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Rita Prota
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Bianca Cinicola
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Anna Maria Zicari
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Marina Aloi
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Salvatore Oliva
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
| | - Gianluca Terrin
- Department of Maternal and Child Health, Policlinico Umberto I Hospital, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (M.G.C.); (G.B.); (C.P.); (L.D.); (D.R.); (M.D.C.); (G.B.); (R.P.); (B.C.); (A.M.Z.); (M.A.); (S.O.)
- Correspondence: ; Tel.: +39-064-997-2536
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