Cohort Study of Maternal Gestational Weight Gain, Gestational Diabetes, and Childhood Asthma

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.

Pregnancy‐ and birth‐related risk factors for the development of childhood celiac disease

“…The MMCC prebirth cohort was generated using three main data sources: electronic health record data for children born at MGH between 1998 and 2016, birth certificate data from the Massachusetts Department of Public Health for these same children, and health record data for mothers who enrolled in prenatal care at MGH and affiliated health centres during 1998–2016 (the MGH Maternal Health Cohort). Two recently published MMCC‐based studies may provide further information about our cohort's characteristics 14,15 . All children who had at least one health care encounter by the age of 5 years were included in the analysis.…”

“…Two recently published MMCC-based studies may provide further information about our cohort's characteristics. 14,15 All children who had at least one health care encounter by the age of 5 years were included in the analysis. Data of interest included maternal pregnancy variables (eg age at birth, race/ethnicity, body weight, body mass index, pounds of weight gain during pregnancy, gestational diabetes and hypertensive disorder of pregnancy), mode of delivery (ie vaginal or Caesarean delivery [with labour or without labour]) and data from their offspring (eg sex, month of birth, low birth weight [defined as <2500 g], multiple gestation, prematurity [defined as birth at <37 weeks gestational age]).…”

The relation of prenatal acid suppressant medication exposure to severe bronchiolitis and childhood asthma

“…We performed a retrospective cohort study using data from the Massachusetts General Hospital (MGH) Maternal Child Cohort (MMCC), which included 37,510 pregnant individuals linked to 53,802 children born between 1998 and 2016. This cohort was created by linking several datasets, including the hospital's obstetric medical record system and Massachusetts Department of Public Health birth certificate data, as previously described 5 . This study was approved by the Mass General Brigham Human Research Committee.…”

“…This cohort was created by linking several datasets, including the hospital's obstetric medical record system and Massachusetts Department of Public Health birth certificate data, as previously described. 5 This study was approved by the Mass General Brigham Human Research Committee.…”