Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

Christine Stabell Benn; Poul Thorsen; Jørgen Skov Jensen; Birgitte Boysen Kjær; Hans Bisgaard; Morten Andersen; Klaus Rostgaard; Bengt Björkstén; Mads Melbye

doi:10.1067/mai.2002.125833

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Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

Christine Stabell Benn, MD^a

Poul Thorsen, MD, PhD^b

Jørgen Skov Jensen, MD, PhD^c

Birgitte Boysen Kjær, MD^c

Hans Bisgaard, MD, DMSc^d

Morten Andersen, MD, PhD^e

Klaus Rostgaard, MSc^a

Bengt Björkstén, MD, DMSc^f

Mads Melbye, MD, DMSc^a

Copenhagen, Aarhus, and Odense, Denmark, and Stockholm, Sweden

From ^athe Department of Epidemiology Research, Danish Epidemiology Science Centre, Statens Serum Institut, Copenhagen; ^bthe Department of Epidemiology and Social Medicine, Aarhus University, Aarhus; ^cMycoplasma Laboratory, Statens Serum Institut, Copenhagen; ^dthe Department of Pediatrics, Rigshospitalet, Copenhagen; ^ethe Department of Clinical Pharmacology, Institute of Public Health, University of Southern Denmark, Odense; and ^fthe Centre for Allergy Research and Institute of Environmental Medicines, Karolinska Institutet, Stockholm

DOI: https://doi.org/10.1067/mai.2002.125833

Abstract

Background: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence the establishment of the infant flora and, as a consequence, the development of wheezing and allergic diseases. Objective: We sought to study the associations between the composition of the maternal vaginal microflora and the development of wheezing and asthma in childhood. Methods: We performed a population-based cohort study in Denmark. Vaginal samples for bacterial analysis were obtained during pregnancy. A total of 2927 women (80% of the invited women) completed the study and had 3003 live infants. Infant wheezing was assessed as one or more hospitalizations for asthma between 0 and 3 years of age. Asthma was assessed as use of 3 or more packages of antiasthma medication between 4 and 5 years of age. Results: Maternal vaginal colonization with Ureaplasma urealyticum during pregnancy was associated with infant wheezing (odds ratio [OR], 2.0; 95% CI, 1.2-3.6), but not with asthma, during the fifth year of life. Maternal colonization with staphylococci (OR, 2.2; 95% CI, 1.4-3.4) and use of antibiotics in pregnancy (OR, 1.7; 95% CI, 1.1-2.6) were associated with asthma during the fifth year of life. Conclusion: The composition of the maternal vaginal micro-flora might be associated with wheezing and asthma in the offspring up to 5 years of age. (J Allergy Clin Immunol 2002;110:72-7.)

Keywords:

Asthma, wheezing, childhood, maternal vaginal, microflora, Ureaplasma urealyticum, staphylococci, antibiotics

Abbreviations:

ICD (International Classification of Diseases), OPED (Odense Pharmacoepidemiologic Database), OR (Odds ratio)

☆Supported by grants from The Danish Medical Research Council (9700560). The original study was supported by the Danish National Research Foundation and a grant from March of Dimes Birth Defects Foundation (#20-FY98-700), New York, and supported under a cooperative agreement from the Centers for Disease Control and Prevention, Atlanta, Ga, through the Association of Teachers of Preventive Medicine, Washington, DC. The activities of The Danish Epidemiology Science Centre are financed by a grant from The Danish National Research Foundation.

☆☆Reprint requests: Christine Stabell Benn, MD, Department of Epidemiology Research, Statens Serum Institut, 5 Artillerivej, DK-2300 Copenhagen S, Denmark.

Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

Abstract

Keywords:

Abbreviations:

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