The impact of maternal asthma during pregnancy on fetal growth and development: a review

ABSTRACT

Introduction

Asthma is a highly prevalent co-morbidity during pregnancy that can worsen as gestation progresses and is associated with several adverse perinatal outcomes. These adverse outcomes often result from uncontrolled asthma during pregnancy and acute asthma exacerbations that are associated with alterations in placental function and fetal growth.

Areas covered

This paper will discuss how maternal asthma in pregnancy affects fetal growth and development which may alter future offspring health. Changes in placental function occur in a sex-specific manner in pregnancies complicated by asthma and result in differences in fetal growth and development which may influence child health. The follow up of children from mothers with asthma suggests they are at greater risk of developing asthma, have alterations in microvascular structure that may contribute to a future risk of cardiovascular disease and epigenetic modifications in immune cell function. The current evidence suggests that appropriately managed asthma during pregnancy results in normal fetal growth and development.

Expert opinion

Clinical management of asthma during pregnancy needs significant improvement to prevent adverse outcomes for the fetus. The key to improving maternal and fetal outcomes is through education of health professionals and parents about controlling asthma during pregnancy.

KEYWORDS:

• Maternal asthma
• pregnancy
• fetal sex
• placenta

Article highlights

• Maternal asthma is a common chronic disease to affect pregnancy

• Uncontrolled maternal asthma during pregnancy has a detrimental effect on the placenta and fetus

• Uncontrolled asthma during pregnancy is associated with childhood disease

• Management of asthma during pregnancy is a clinical area of unmet need

• Respiratory nurse-led antenatal care is a cost-effective solution to improving outcomes for pregnant women with asthma.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

VLC is supported by an NHMRC SRF (APP1136100). ASM was supported by an Australian Postgraduate Awards from the Australian Government. ASM, NS, ZS & VLC were supported by Mater Foundation and Translational Research Institute.