Association between hypertensive disorders of pregnancy and the risk of asthma, eczema and allergies in offspring: A systematic review and meta-analysis

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dc.contributor.author Conlan, Nicola
dc.contributor.author Maher, Gillian M.
dc.contributor.author Al Khalaf, Sukainah Y.
dc.contributor.author McCarthy, Fergus P.
dc.contributor.author Khashan, Ali S.
dc.date.accessioned 2020-11-18T12:51:36Z
dc.date.available 2020-11-18T12:51:36Z
dc.date.issued 2020-10-09
dc.identifier.citation Conlan, N., Maher, G. M., Al Khalaf, S. Y., McCarthy, F. P. and Khashan, A. S. (2020) 'Association between hypertensive disorders of pregnancy and the risk of asthma, eczema and allergies in offspring: A systematic review and meta-analysis', Clinical and Experimental Allergy. doi: 10.1111/cea.13754 en
dc.identifier.issn 0954-7894
dc.identifier.uri http://hdl.handle.net/10468/10773
dc.identifier.doi 10.1111/cea.13754 en
dc.description.abstract Objective: Conduct a systematic review and meta‐analysis examining the association between hypertensive disorders of pregnancy (HDP) and risk of asthma, eczema, food allergies and allergic rhinitis in the offspring. Design: A systematic review and random‐effects meta‐analyses were used to synthesize the published literature. PRISMA guidelines were followed throughout. Two independent reviewers carried out data extraction and quality assessment of included studies. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings. Data Sources: A systematic search of PubMed, Embase, Web of Science and CINAHL was performed from inception of databases‐21 April 2020, supplemented by hand‐searching reference lists of included articles. Eligibility Criteria: Two reviewers independently reviewed titles, abstracts and full‐text articles. English language, cohort, case‐control and cross‐sectional published studies examining the association between HDP (primary exposure: pre‐eclampsia; secondary exposures: all other HDP) and asthma, eczema, food allergies and allergic rhinitis were included. Results: Of the 2833 studies retrieved, 14 studies met inclusion criteria. Of these, 11 studies reported evidence of association between HDP and atopic disorders. Thirteen studies reported estimates for asthma. Seven of these included adjusted estimates (including 3 645 773 participants) for a pre‐eclampsia‐asthma relationship resulting in a pooled odds ratio (OR) of 1.14 (95% CI: 1.04, 1.26) (I2 = 62%). However, this OR was reduced to 1.08 (95% CI: (0.78, 1.48) when the large registry‐based cohort studies were excluded, and only studies using parent‐reported measures to determine a diagnosis of asthma were included. Four studies included adjusted estimates (including 254 998 participants) for other HDP and asthma (pooled OR: 1.02, 95% CI: 0.96, 1.09) (I2 = 0%). Two studies provided adjusted estimates (including 1 699 663 participants) for a pre‐eclampsia‐eczema relationship (pooled OR: 1.06, 95% CI: 0.98, 1.14) (I2 = 0%). One study including pre‐eclampsia‐food allergies was identified (OR: 1.28, 95% CI: 1.11, 1.46). Three studies examined a HDP (including pre‐eclampsia) and allergic rhinitis relationship, with effect estimates ranging from 1.14 to 2.10. Studies were classified as low or low‐moderate risk of bias, while GRADE certainty of findings were low to very low. Conclusions: While pre‐eclampsia was associated with a possible increased risk of asthma in offspring, there was no evidence for a relationship between other HDP and asthma. There is a lack of published literature examining the association between HDP and eczema, food allergy and allergic rhinitis. Further primary research is warranted to gain a better understanding of the association between HDP and the risk of childhood atopic disease. en
dc.description.sponsorship Health Research Board (Grant Number: SDAP2019/6359) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons, Inc. en
dc.rights © 2020, John Wiley & Sons, Ltd. This is the peer reviewed version of the following article: Conlan, N., Maher, G. M., Al Khalaf, S. Y., McCarthy, F. P. and Khashan, A. S. (2020) 'Association between hypertensive disorders of pregnancy and the risk of asthma, eczema and allergies in offspring: A systematic review and meta-analysis', Clinical and Experimental Allergy, doi: 10.1111/cea.13754, which has been published in final form at https://doi.org/10.1111/cea.13754. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. en
dc.subject Hypertensive disorders of pregnancy en
dc.subject HDP en
dc.subject Asthma en
dc.subject Eczema en
dc.subject Food allergies en
dc.subject Allergic rhinitis en
dc.title Association between hypertensive disorders of pregnancy and the risk of asthma, eczema and allergies in offspring: A systematic review and meta-analysis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Gillian Maher, Infant Research Centre, University College Cork, Cork, Ireland. +353-21-490-3000 Email: gillian.maher@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2021-10-09
dc.date.updated 2020-11-18T12:41:24Z
dc.description.version Accepted Version en
dc.internal.rssid 541188016
dc.internal.pmid 33037716
dc.contributor.funder Health Research Board en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Clinical and Experimental Allergy en
dc.internal.copyrightchecked Yes
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress gillian.maher@ucc.ie en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation and copyright statement as necessary. en
dc.identifier.eissn 1365-2222


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