To evaluate the association between gestational age at birth and the risk of subsequent development of asthma.
We conducted a retrospective observational hospital-based birth case-control study in a university-based obstetrics and gynecology department in Finland. A total of 44,173 women delivering between 1989 and 2008 were linked with the social insurance register to identify asthma reimbursements for their offspring (n = 2661). Pregnancy factors were recorded during pregnancy. Infants were categorized as moderately preterm (= 32 weeks), late preterm (33-36 weeks), early term (37-38 weeks), term (39-40 weeks), or late term and postterm (= 41 weeks). The main outcome measure was asthma among the infants.
Children born moderately preterm (= 32 weeks gestation) had a significantly increased risk of asthma (aOR, 3.9; 95% CI, 3.2-4.8). The risk of asthma was also increased in those born late preterm (aOR, 1.7; 95% CI, 1.4-2.0) and early term (aOR, 1.2; 95% CI, 1.1-1.4). In contrast, delivery at 41 weeks or later seemed to decrease the risk of asthma (aOR, 0.9; 95% CI, 0.8-1.0). The burden of asthma associated with preterm birth was associated mainly with early term infants, in whom 108 extra cases of asthma were observed.
Even though the individual risk of asthma was inversely correlated with gestational age at birth, the overall burden brought about by delivery before term was associated with late preterm and early term deliveries. Furthermore, delivery after term was protective against asthma.
To study whether genetic variability in the gene encoding endothelial nitric oxide synthase (eNOS) affects individual susceptibility to the development of placental abruption during pregnancy.
One hundred and sixteen pregnant women with placental abruption and 113 healthy controls were genotyped for Glu298Asp polymorphism in the eNOS gene. Chi-square analysis was used to assess the differences in genotype and allele frequencies between the two groups.
A statistically similar allelic distribution of eNOS Glu298Asp polymorphism was observed in the two groups, with the frequency of the variant G allele being 66.8% in the abruption group and 68.1% in the control group (OR 0.94, 95% CI: 0.64-1.39; p = 0.76). The genotype distribution of the eNOS polymorphism was also found to be statistically similar (p = 0.72).
The observed genotype data in subjects from eastern Finland suggest that the Glu298Asp polymorphism of the eNOS gene does not contribute to placental abruption in this population.
The purpose was to study the prevalence of environmental intolerance (EI) and its different manifestations, including behavioral changes and disability. Fertile-aged women (n = 680) of the Kuopio Birth Cohort Study were asked about annoyance to 12 environmental factors, symptoms and behavioral changes. We asked how much the intolerance had disrupted their work, household responsibilities or social life. We chose intolerance attributed to chemicals, indoor molds, and electromagnetic fields to represent typical intolerance entities. Of the respondents, 46% reported annoyance to chemicals, molds, or electromagnetic fields. Thirty-three percent reported symptoms relating to at least one of these three EIs, 18% reported symptoms that included central nervous system symptoms, and 15% reported behavioral changes. Indicating disability, 8.4% reported their experience relating to any of the three EIs as at least "somewhat difficult", 2.2% "very difficult" or "extremely difficult", and 0.9% "extremely difficult". Of the latter 2.2%, all attributed their intolerance to indoor molds, and two thirds also to chemicals. As the number of difficulties increased, the number of organ systems, behavioral changes and overlaps of the three EIs also grew. EI is a heterogeneous phenomenon and its prevalence depends on its definition. The manifestations of EI form a continuum, ranging from annoyance to severe disability.
Cites: J Gen Intern Med. 2001 Sep;16(9):606-13 PMID 11556941
Cites: Int Arch Occup Environ Health. 2005 Aug;78(7):559-64 PMID 16001204
Low-grade inflammation in early childhood might protect from allergic diseases later in life. Our aim was to examine the effects of different environmental factors on low-grade inflammation measured with serum high-sensitivity C-reactive protein (hsCRP) at the age of 4.5 years.
The high-sensitivity CRP values (n = 653) and serum-specific IgE concentrations were measured from 4.5-year-old children in rural areas in five European countries (Austria, Finland, France, Germany, and Switzerland). Children belonged to the prospective multi-center PASTURE birth cohort. Data on early and current farming environment and domestic animal exposure were collected by questionnaires.
Females as well as obese or very obese children at age of 4.5 years had higher hsCRP values than males (aOR 1.84 95% CI 1.27-2.66) and healthy weight children (aOR 4.47 95% CI 1.94-10.31), respectively. Levels were lowest in the summer. Few associations were detected between hsCRP values and farm environmental factors or atopic sensitization. However, there was evidence of children with low levels of hsCRP (below the detection limit) who had increased prevalence of sensitization to inhaled and seasonal allergens. Among non-sensitized children, spending time in stables was associated with reduced hsCRP (15 min-10 h aOR 0.40 95% CI 0.16-0.96 and =10 h aOR 0.25 95% CI 0.07-0.90), and among sensitized children, maternal smoking was associated with higher hsCRP values (aOR 2.51 95% CI 1.12-5.59).
We found few associations between early environmental farming factors and hsCRP levels, and between hsCRP levels and atopic sensitization in 4.5-year-old children. However, our results suggest that the role played by the environmental factors in low-grade inflammation may differ between sensitized and non-sensitized children.
Microbial colonization of the airways and intestine during birth might have an effect on the risk of asthma and allergic diseases later in life.
We sought to evaluate the association between intrauterine microbial growth at the time of delivery and the development of asthma and allergic sensitization among offspring.
Intrauterine bacterial culture results were recorded at the time of cesarean delivery of 460 children who were born at Kuopio University Hospital during 1990-1992. When the children reached the age of 15 to 17 years, self-administered questionnaires were sent to the mothers, and 382 of the children were also examined by using skin prick tests.
Intrauterine growth of potential pathogenic anaerobic bacteria and Streptococcus species at birth was associated with an increased risk of doctor-diagnosed asthma ever (odds ratio [OR], 4.51 [95% CI, 1.56-13.0]; OR, 2.53 [95% CI, 1.19-5.38]) and doctor-diagnosed current asthma (OR, 7.34 [95% CI, 2.44-22.03]; OR, 3.37 [95% CI, 1.46-7.76]) at the age of 15 to 17 years compared with the risk seen in subjects with negative microbial cultures. These findings remained significant also after applying the Bonferroni correction. No significant association after the Bonferroni correction was detected between intrauterine microbial growth and allergic sensitization among offspring.
The results of this study indicated that specific intrauterine microbial growth at the time of birth might increase the risk of asthma among offspring through inflammatory mechanisms. These results indicate new potential targets for future studies on the effects of maternal vaginal microflora and intrauterine infection in the development of asthma among children.
A Finnish joint research effort Kuopio Birth Cohort (KuBiCo) seeks to evaluate the effects of genetics, epigenetics and different risk factors (medication, nutrition, lifestyle factors and environmental aspects) during pregnancy on the somatic and psychological health status of the mother and the child.
KuBiCo will ultimately include information on 10,000 mother-child pairs who have given their informed consent to participate in this cohort. Identification of foetal health risk factors that can potentially later manifest as disease requires a repository of relevant biological samples and a flexible open up-to-date data handling system to register, store and analyse biological, clinical and questionnaire-based data. KuBiCo includes coded questionnaire-based maternal background data gathered before, during and after the pregnancy and bio-banking of maternal and foetal samples that will be stored in deep freezers. Data from the questionnaires and biological samples will be collected into one electronic database. KuBiCo consists of several work packages which are complementary to each other: Maternal, foetal and placental metabolism and omics; Paediatrics; Mental wellbeing; Prenatal period and delivery; Analgesics and anaesthetics during peripartum period; Environmental effects; Nutrition; and Research ethics.
This report describes the set-up of the KuBiCo and descriptive analysis from 3532 parturients on response frequencies and feedback to KuBiCo questionnaires gathered from June 2012 to April 2016. Additionally, we describe basic demographic data of the participants (n?=?1172). Based on the comparison of demographic data between official national statistics and our descriptive analysis, KuBiCo represents a cross-section of Finnish pregnant women.
To evaluate the association between maternal socioeconomic status (SES) during pregnancy and asthma among offspring.
A retrospective observational hospital-based birth cohort study in a university-based Obstetrics and Gynecology department in Finland. A total of 40 118 women with singleton live births between 1989 and 2007 were linked with data from the register for asthma medication for their offspring (n = 2518). Pregnancy and maternal SES factors were recorded during pregnancy and labor. SES was categorized thus: upper white-collar workers (highest SES), lower white-collar workers, blue-collar workers, others (lowest SES) and cases with missing information. Logistic regression analysis was used to determine the association between maternal SES and childhood asthma.
We found no convincing evidence of a direct association between maternal SES and childhood asthma. Parental smoking was the clearest factor affecting asthma among children of lower white-collar workers. Differences in pregnancy and delivery characteristics were observed between the SES groups.
Maternal socioeconomic status had no significant direct impact on the prevalence of asthma in this Finnish birth cohort. Finnish public health services appeared to offer equal quality services independently of SES.
The study is registered in Kuopio University Hospital register (TUTKI): ID 5302448 .
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Cites: Eur J Public Health. 2014 Aug;24(4):544-5124025664
The aim of our study was to examine genetic variability in the gene encoding methylenetetrahydrofolate reductase (MTHFR) and individual susceptibility to the placental abruption or preeclampsia.
362 women (133 with preeclampsia, 117 with placental abruption, and 112 healthy controls) were genotyped for C677T polymorphism in the MTHFR gene.
Similar genotype distributions were observed in the frequencies of C/C homozygotes (58.6%, 64.1%, and 57.1% for the three groups, respectively) and mutant homozygotes T/T (9.0%, 5.1% and 5.4%). No significant differences were detected in T allele frequencies (25.2%, 20.5%, and 24.1% for the three groups, respectively).
MTHFR C677T polymorphism does not have a major role in the development of preeclampsia or placental abruption in the Finnish population.
To evaluate the association between maternal and paternal smoking during pregnancy, and asthma among offspring.
We conducted a hospital-based birth retrospective observational birth cohort study in a University-based Obstetrics and Gynecology Department, Kuopio University Hospital, Finland. 39 306 women, delivering between 1989 and 2006, were linked to the national register for asthma reimbursement for their offspring (2641 asthmatics). Pregnancy factors were recorded during pregnancy.
The risk of asthma was significantly elevated if both parents smoked (aOR 3.7; 95 % Cl 3.2-4.4) and it remained high in only paternal smoking families (aOR 2.9; 95 % Cl 2.5-3.3) as well as only maternal smoking families (aOR 1.7; 95 % Cl 1.2-2.2). Paternal cessation of smoking during pregnancy seemed to reduce the risk of asthma regardless of maternal smoking (aOR 0.3-0.4).
Parental smoking, and especially paternal smoking, was significantly associated with the risk of asthma in offspring and paternal cessation of smoking during pregnancy was associated with a decreased risk of childhood asthma regardless of maternal smoking. The results indicate that both parents should be encouraged to quit smoking during pregnancy, since it is a relatively easy and cheap way to reduce the risk of asthma in offspring.
The study is registered in Kuopio University Hospital register (TUTKI): ID5302448.
Cites: Am J Epidemiol. 2000 Aug 1;152(3):219-2510933268
The purpose of this study was to explore the maternal risk profile and obstetric outcome in pregnancies affected by placenta previa. Retrospective case-control study involved all women (93 [0.37%] women with diagnosed placenta previa and 24,857 unaffected controls) who gave birth to singleton infants at Kuopio University Hospital between the years 1989 and 2000. Grand multiparity, infertility problems, and advanced maternal age were independent risk factors of placenta previa, with adjusted relative risks of 5.8, 3.7, and 2.4, respectively. Most women with placenta previa (88.2%) underwent cesarean delivery before term. They also more often had velamentous umbilical cord insertion (7.5%) and higher placental-to-birthweight ratios than the controls. Placenta previa was associated with risks of preterm delivery, low birthweight infants, and need for neonatal intensive care, at odds ratios of 27.7, 7.4, and 3.4, respectively. In conclusion, placenta previa is an infrequent pregnancy complication associated with multiparity, advanced maternal age, infertility problems, elevated placental ratio, and velamentous umbilical cord insertion.