Fetal Exposure to Maternal Pregnancy Complications and Respiratory Health in Childhood

Background: A number of studies have highlighted that prenatal adverse events can affect the offspring's health status. We evaluated whether pregnancy complications might affect the respiratory health of the offspring during infancy and childhood. Methods: In 2006, all the children (3-14 years, N = 3,907) living in the Viadana district (Mantua, Italy) were surveyed through a parental questionnaire about pregnancy complications (hypertensive disorders, febrile infections, gynecological infections) and early-life and current respiratory diseases. Hospital discharge records for respiratory diseases were obtained for a 6-year follow-up period (2007-2012). Association estimates were adjusted for maternal smoking during pregnancy, maternal age at delivery, type and term of delivery, and other potential confounders. Results: A total of 3,617 (93%) children were included in the analyses. Pregnancy complications were significantly associated with higher risk of respiratory diseases during infancy and childhood. In particular, children exposed to gynecological infections were more likely to have bronchitis [odds ratio (OR): 1.48, 95% confidence interval (95% CI): 1.04-2.10], pneumonia (OR: 2.05, 95% CI: 1.10-3.81), and wheezing (OR: 1.49, 95% CI: 1.00-2.23) at 0-2 years; to report asthma (OR: 3.57, 95% CI: 1.59-8.04) and cough/phlegm (OR: 2.68, 95% CI: 1.67-4.31) at the time of the survey; and to be hospitalized for respiratory diseases (hospitalization hazard ratio: 1.74, 95% CI: 1.02-2.97) in the 6-year follow-up. There was a significant association between febrile infections and wheezing in infancy, even in children whose mothers did not use paracetamol or antibiotics during pregnancy. Conclusions: This observational study suggests that pregnancy complications, especially gynecological infections, might affect the offspring's respiratory health throughout infancy and childhood.