Beta-2 receptor agonist exposure in the uterus associated with subsequent risk of childhood asthma

Pediatr Allergy Immunol. 2017 Dec;28(8):746-753. doi: 10.1111/pai.12805. Epub 2017 Oct 3.

Abstract

Background: Although the beta-2 receptor agonist (B2RA) is occasionally prescribed in the prenatal period for women with preterm labor, few studies have referred to the long-term effects of intrauterine exposure to B2RA on fetus. We examined the association between intrauterine exposure to B2RA and asthma in the offspring.

Methods: We obtained data from a hospital-based birth cohort study conducted in Tokyo, Japan. The outcomes of interest were three indicators, consisting of current wheeze, current asthma, and ever asthma at 5 years of age, based on the International Study of Asthma and Allergies in Childhood questionnaire. Logistic regression analysis was used to evaluate the association between intrauterine B2RA exposure and outcomes. To evaluate dose-dependent risk, we categorized children into three groups according to both the cumulative dose and duration (days) and conducted trend analysis.

Results: Of 1158 children, 94 (8.1%) were exposed to B2RA in utero, and 191 (16.5%), 111 (9.6%), and 168 (14.5%) children experienced current wheeze, current asthma, and ever asthma, respectively. After adjusting for confounders, we found an increased risk of current asthma caused by B2RA exposure with an adjusted odds ratio of 2.04 (95% confidence interval: 1.02-4.05). Trend analysis showed that B2RA exposure in utero was associated with a dose-dependent increased risk of current asthma in terms of both cumulative dose and duration (P values for trend were .015 and .017, respectively). These results were similar to those for other outcome measures.

Conclusion: Exposure to B2RA in utero could be a risk for childhood asthma.

Keywords: beta-2 receptor agonist; childhood asthma; dose dependent; maintenance tocolysis; pregnancy.

MeSH terms

  • Adrenergic beta-2 Receptor Agonists / adverse effects*
  • Asthma / chemically induced*
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Odds Ratio
  • Pregnancy
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Prospective Studies
  • Risk Factors

Substances

  • Adrenergic beta-2 Receptor Agonists