Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Preeclampsia & Maternal and Offspring Asthma

Am J Respir Crit Care Med; ePub 2018 Aug 28; Mirzakhani, et al

Preeclampsia is associated with increased risk of early life childhood asthma in children aged < 3 years and was associated with maternal asthma alone, a recent study found. 806 pregnant women and their offspring were followed from enrollment (10-18 weeks) through the child’s third birthday. The primary outcome was child asthma as determined by parental report of a physician-diagnosis. Researchers found:

  • Asthma incidence in children aged 3 years was 9.90%, 16.22%, 22.11%, and 32.14% among those born to non-asthmatic mothers without preeclampsia, non-asthmatic mothers with preeclampsia, asthmatic mothers without preeclampsia, and asthmatic mothers with preeclampsia, respectively.
  • There was an increasing trend in risk of child asthma across maternal groups.
  • After adjustment, asthma risk was greater among children born to asthmatic mothers without preeclampsia compared with non-asthmatics without preeclampsia.
  • This risk was 50% greater for children born to asthmatic mothers with preeclampsia during pregnancy.


Mirzakhani H, Carey VJ, McElrath TF, et al. Impact of preeclampsia on the relationship of maternal asthma with offspring asthma: An observation from the VDAART clinical trial. [Published online ahead of print August 28, 2018]. Am J Respir Crit Care Med. doi:10.1164/rccm.201804-0770OC.


Asthma is disease caused by genetic and environmental interaction. While most environmental influences on asthma occur after birth and early years of childhood, some may impact the disease late in life and some may do that before birth in utero. The results of this study are very interesting suggesting and interaction between the presence of preeclampsia during pregnancy and increased prevalence of asthma in the offspring, especially so in mothers who are asthmatics. This suggests possible common pathophysiologic pathways that predispose to increased risk of asthma in genetically susceptible individuals. While these findings need to be replicated and the biological plausibility needs to be examined, they suggest that preeclampsia is a risk factor for asthma in childhood. Whether early detection and management of preeclampsia can reduce that risk will also need to be examined. —Nicola Hanania, MD, MS