Abstrak: The objective of this study was to examine the association between maternal asthma medication use during the periconceptional period and the risk of gastroschisis. In this case-control study, the authors used data on deliveries enrolled in the National Birth Defects Prevention Study (1997-2002) from eight collaborating centers. The cases included 381 infants with isolated gastroschisis, and the controls were 4,121 liveborn infants without malformations. The asthma medications used during the periconceptional period (1 month prepregnancy through the third pregnancy month) were divided into two groups, antiinflammatory and bronchodilator, and analyzed separately. Users of multiple asthma medications during the periconceptional period were also examined. Logistic regression was used to estimate odds ratios and 95% confidence intervals while controlling for maternal age, race/ethnicity, education, smoking, folic acid/vitamin use, and other vasoactive medications. Maternal bronchodilator use showed an elevated statistically significant risk of gastroschisis (adjusted odds ratio = 2.06, 95% confidence interval: 1.19, 3.59). No significant association was found between maternal use of asthma antiinflammatory medications and gastroschisis. Because information on maternal asthma status/severity was not available, the effects of disease on the risk of gastroschisis cannot be ruled out. Additional research is needed in determining whether a real risk exists and for guiding asthma treatment.

Abstrak: The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected. The associations between perinatal factors, derived from the Finnish Medical Birth Register, and the risk of asthma were analyzed by conditional logistic regression. In the final multivariate model, maternal asthma, young age, smoking, previous miscarriages, and a high number of previous deliveries, as well as cesarean section, low gestational age, and low ponderal index, were associated with an increased risk of asthma in children diagnosed before the age of 3 years. Among children diagnosed at the age of 3 years or later, maternal asthma, low gestational age, and low ponderal index were associated with an increased risk, and a high number of previous deliveries was associated with a decreased risk of asthma. In conclusion, perinatal factors play a role in the development of asthma in childhood, but the etiology may differ in early and late-onset asthma.