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

dc.check.date2021-10-09
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorConlan, Nicola
dc.contributor.authorMaher, Gillian M.
dc.contributor.authorAl Khalaf, Sukainah
dc.contributor.authorMcCarthy, Fergus P.
dc.contributor.authorKhashan, Ali S.
dc.contributor.funderHealth Research Boarden
dc.date.accessioned2020-11-18T12:51:36Z
dc.date.available2020-11-18T12:51:36Z
dc.date.issued2020-10-09
dc.date.updated2020-11-18T12:41:24Z
dc.description.abstractObjective: 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.sponsorshipHealth Research Board (Grant Number: SDAP2019/6359)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationConlan, 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.13754en
dc.identifier.doi10.1111/cea.13754en
dc.identifier.eissn1365-2222
dc.identifier.issn0954-7894
dc.identifier.journaltitleClinical and Experimental Allergyen
dc.identifier.urihttps://hdl.handle.net/10468/10773
dc.language.isoenen
dc.publisherJohn 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.subjectHypertensive disorders of pregnancyen
dc.subjectHDPen
dc.subjectAsthmaen
dc.subjectEczemaen
dc.subjectFood allergiesen
dc.subjectAllergic rhinitisen
dc.titleAssociation between hypertensive disorders of pregnancy and the risk of asthma, eczema and allergies in offspring: A systematic review and meta-analysisen
dc.typeArticle (peer-reviewed)en
Files
Original bundle
Now showing 1 - 2 of 2
Loading...
Thumbnail Image
Name:
14193.pdf
Size:
9.53 MB
Format:
Adobe Portable Document Format
Description:
Accepted Version
Loading...
Thumbnail Image
Name:
cea13754-sup-0001-appendixs1-s13.docx
Size:
76.74 KB
Format:
Microsoft Word XML
Description:
Supporting Information
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
2.71 KB
Format:
Item-specific license agreed upon to submission
Description: