Maternal Asthma, its Control and Severity in Pregnancy, and the Incidence of Atopic Dermatitis and Allergic Rhinitis in the Offspring

Objective To evaluate the relationship between maternal asthma, its level of control and severity during pregnancy, and atopic dermatitis (AD) and allergic rhinitis (AR) incidence in children. Study design A cohort of 26 265 singletons born to mothers with and without asthma (1990-2002) was constituted by use of 3 Quebec databases. Mothers with asthma had to have received >= 1 diagnosis and >= 1 prescription for asthma 2 years before or during pregnancy. Asthma control and severity during pregnancy was based on validated indexes. ICD-9 codes 691 and 477 allowed us to identify cases of AD and AR. Results Maternal asthma during pregnancy was associated with an increased AD risk (adjusted hazard ratio: 1.11, 95% confidence interval: 1.02-1.21), but not of AR (adjusted hazard ratio: 1.04, 95% confidence interval: 0.91-1.20) in children. Asthma control and severity were not associated with either outcome. Maternal AR and intranasal corticosteroid use during pregnancy increased the risk of childhood AR by 70% and 45%. Conclusions Children of mothers with asthma or AR during pregnancy should be closely monitored to diagnose and treat AD and AR as early as possible. (J Pediatr 2009; 155: 707-13).