Prescribed analgesics in pregnancy and risk of childhood asthma

Many epidemiological studies have reported a positive association between prenatal exposure to paracetamol and childhood wheezing and asthma. We investigated whether the link between prenatal analgesic exposure and asthma/wheeze is specific to paracetamol, and whether it is causal or confounded.Using linked Swedish health register data we investigated the relation between various prescribed analgesics in pregnancy and the risk of childhood asthma/wheeze in a population of 492 999, and used negative paternal control and sibling comparison approaches to explore unmeasured confounding.After controlling for potential confounders, prescribed opioids, antimigraine drugs and paracetamol were all positively associated with childhood asthma/wheeze risk at all ages (e.g. for asthma/wheeze at age 4 years: adjusted OR 1.39 (95% CI 1.30–1.49), 1.19 (95% CI 1.01–1.40) and 1.47 (95% CI 1.36–1.59) for opioids, antimigraine drugs and paracetamol, respectively). The results of the paternal control analysis did not suggest the presence of unmeasured confounding by genetics or shared environment. However, the sibling control analysis broadly suggested that associations between prenatal exposure to the analgesics and asthma/wheeze were confounded by specific maternal factors (e.g. for asthma/wheeze at age 4 years: adjusted OR 0.91 (95% CI 0.62–1.31), 0.50 (95% CI 0.17–1.45) and 0.80 (95% CI 0.50–1.29) for opioids, antimigraine drugs and paracetamol, respectively).We propose that analgesic use in pregnancy does not cause childhood asthma/wheeze and that the association is confounded by unmeasured factors that are intrinsic to the mother, such as chronic pain or anxiety.

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Prenatal exposure to persistent organic pollutants as a risk factor of offspring metabolic syndrome development during childhood

Reviews on Environmental Health ◽

10.1515/reveh-2020-0113 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Marlene Cervantes González

Keyword(s):

Metabolic Syndrome ◽

Organic Pollutants ◽

Prenatal Exposure ◽

Persistent Organic Pollutants ◽

Animal Studies ◽

Polychlorinated Biphenyl ◽

Environmental Pollutants ◽

Epidemiological Studies ◽

Experimental Findings

Abstract Persistent Organic Pollutants (POPs) are exogenous, artificially made chemicals that can disrupt the biological system of individuals and animals. POPs encompass a variety of chemicals including, dioxins, organochlorines (OCs), polychlorinated biphenyl (PCBs), and perfluoroalkyl substances (PFASs) that contain a long half-life and highly resistant to biodegradation. These environmental pollutants accumulate over time in adipose tissues of living organisms and alter various insulin function-related genes. Childhood Metabolic Syndrome (MetS) consists of multiple cardiovascular risk factors, insulin function being one of them. Over the years, the incidence of the syndrome has increased dramatically. It is imperative to explore the role of persistent organic pollutants in the development of Childhood Metabolic Syndrome. Some epidemiological studies have reported an association between prenatal exposure to POPs and offspring MetS development throughout childhood. These findings have been replicated in animal studies in which these pollutants exercise negative health outcomes such as obesity and increased waist circumference. This review discusses the role of prenatal exposure to POPs among offspring who develop MetS in childhood, the latest research on the MetS concept, epidemiological and experimental findings on MetS, and the POPs modes of action. This literature review identified consistent research results on this topic. Even though the studies in this review had many strengths, one major weakness was the usage of different combinations of MetS criteria to measure the outcomes. These findings elucidate the urgent need to solidify the pediatric MetS definition. An accurate definition will permit scientists to measure the MetS as a health outcome properly and allow clinicians to diagnose pediatric MetS and provide individualized treatment appropriately.

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Positive Association Between the Lys198 Asn Polymorphism in the Endothelin-1 and Blood Pressure in Obese Japanese Subjects: Ohasama Study

Hypertension ◽

10.1161/hyp.36.suppl_1.714-c ◽

2000 ◽

Vol 36 (suppl_1) ◽

pp. 714-714

Author(s):

Tomohiro Katsuya ◽

Takayoshi Ohkubo ◽

Yuxiao Fu ◽

Ichiro Tsuji ◽

Kenichi Nagai ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Level ◽

Positive Association ◽

Epidemiological Studies ◽

Buffy Coat ◽

Baseline Characteristic ◽

Endothelin 1 ◽

Overweight People ◽

Obese Subjects

P117 A recent report by Tiret et al. (Hypertension 33, 1999) revealed that a G/T polymorphism with an amino acid substitution (Lys to Asn) at codon 198 in the exon 5 of endothelin 1 gene (ET1) is associated with blood pressure in overweight people using two epidemiological studies, ECTIM and Glasgow Heart Scan Study. They suggested that G/T polymorphism strongly interacted with body mass index (BMI) in the determination of blood pressure levels. To examine the interaction among G/T polymorphism of ET1, BMI and blood pressure, we carried out an association study using a general population. Subjects (n=1,446) were recruited from Ohasama population, which is a cohort in a rural community of northern Japan. The research protocol was approved by the Institutional Review Board of the Tohoku University. DNA was extracted from the buffy coat of the participants using QIAamp DNA Blood Kit (Qiagen Inc.). G/T polymorphism of ET1 was determined by TaqMan PCR method, which is a powerful tool for semiautomatic genotype determination in a large number of samples. The frequency of T198 allele in Japanese (26%) was significantly higher than that in Caucasians (23%). The baseline characteristic (age, BMI, SBP, DBP, antihypertensive treatment) of all subjects was not significantly different according to the genotype of G/T polymorphism. In the obese subjects (≥25kg/m2), however, SBP and DBP were significantly associated with G/T polymorphism. Blood pressure level in the subjects carrying T198 allele was 2.6 mmHg in systolic (p<0.02) and 2.3 mmHg in diastolic (p<0.005) higher than that in those with GG genotype in overweight people. That the same result was obtained from different races suggested that the T198 allele of ET1 is involved in the determination of blood pressure levels in obese subjects.

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Moving toward understanding specific pathways of inflammation in pregnancy: prenatal exposure to consumer product chemicals and changes in plasma eicosanoids

ISEE Conference Abstracts ◽

10.1289/isee.2020.virtual.p-1094 ◽

2020 ◽

Vol 2020 (1) ◽

Author(s):

B.M. Welch ◽

A.P. Keil ◽

J. Erve ◽

L.J. Deterding ◽

J.G. Williams ◽

...

Keyword(s):

Prenatal Exposure ◽

Consumer Product ◽

In Pregnancy

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Obesity in pregnancy

Obstetric Anaesthesia ◽

10.1093/med/9780199688524.003.0016 ◽

2020 ◽

pp. 439-454

Author(s):

Huda Al-Foudri ◽

Stuart Davies ◽

Abrie Theron

Keyword(s):

Obese Woman ◽

Epidemiological Studies ◽

Morbidly Obese ◽

Antenatal Screening ◽

Screening Criteria ◽

Obesity In Pregnancy ◽

Labour Ward ◽

Manual Handling ◽

Body Mass Index Classification ◽

In Pregnancy

Epidemiological studies show the incidence of obesity in pregnancy to be increasing, and the management of the morbidly obese woman on labour ward can be a challenge for anaesthetists. The chapter defines obesity, body mass index, classification, and prevalence, and reviews the physiological effects of obesity on the respiratory, cardiovascular, gastrointestinal, renal, endocrine, and haematological systems, as well as pharmacokinetic changes. Both fetal and maternal morbidities are listed followed by management proposals in the antenatal, peripartum, and postpartum periods. This includes antenatal screening, criteria for anaesthetic referral for assessment and what this should include to plan for delivery. Suggestions for management during labour and during an operative delivery are made. Attention is given to the ramped position and enhanced pre-oxygenation prior to induction of general anaesthesia with CPAP and THRIVE. Practical considerations and technical challenges are discussed and include manual handling, IV access, monitoring, regional techniques, and previous bariatric surgery.

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A combined cohort analysis of prenatal exposure to phthalate mixtures and childhood asthma

Environment International ◽

10.1016/j.envint.2020.105970 ◽

2020 ◽

Vol 143 ◽

pp. 105970

Author(s):

Margaret A. Adgent ◽

Kecia N. Carroll ◽

Marnie F. Hazlehurst ◽

Christine T. Loftus ◽

Adam A. Szpiro ◽

...

Keyword(s):

Prenatal Exposure ◽

Childhood Asthma ◽

Cohort Analysis

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The impact of prenatal exposure to PM2.5 on childhood asthma and wheezing: a meta-analysis of observational studies

Environmental Science and Pollution Research ◽

10.1007/s11356-020-09014-6 ◽

2020 ◽

Vol 27 (23) ◽

pp. 29280-29290 ◽

Cited By ~ 1

Author(s):

Wu Yan ◽

Xu Wang ◽

Tianyu Dong ◽

Mengqi Sun ◽

Mingzhi Zhang ◽

...

Keyword(s):

Prenatal Exposure ◽

Childhood Asthma ◽

Observational Studies ◽

Meta Analysis ◽

The Impact

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Maternal and neonatal complications during pregnancy in women with epilepsy

International Journal of Epilepsy ◽

10.1016/j.ijep.2016.09.001 ◽

2016 ◽

Vol 03 (02) ◽

pp. 080-085

Author(s):

R. Bansal ◽

G. Jain ◽

P. Kharbanda ◽

M. Goyal ◽

V. Suri

Keyword(s):

Epidemiological Studies ◽

Successful Management ◽

Healthy Baby ◽

Neonatal Complications ◽

Neurological Problem ◽

Harmful Effects ◽

In Pregnancy

AbstractEpilepsy is the commonest serious neurological problem faced by obstetricians and gynaecologists. Epidemiological studies estimate epilepsy to complicate 0.3–0.7% of all pregnancies.1 2 The importance of epilepsy in pregnancy lies in the fact that many women with epilepsy (WWE) have to go through their pregnancy while taking antiepileptic (AED) drugs. Both the seizures and AEDs can have harmful effects on the mother as well the foetus. Thus, during pregnancy, the clinician faces dual challenge of controlling seizures as well as preventing teratogenicity of AEDs.1 In this review we discuss the possible impact of seizures as well as AEDs on mother as well as the child. We try to answer some of the commonest questions which are relevant to successful management of pregnancy and ensuring birth of a healthy baby.

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