• Susan Gage, Peiyi Kan, Henry C Lee, Jeffrey B Gould, David K Stevenson, Gary M Shaw, and Hugh M O'Brodovich.
• Department of Pediatrics, Stanford University, Stanford, CA. Electronic address: sgage@stanford.edu.
• J. Pediatr. 2015 Oct 1; 167 (4): 875-880.e1.

ObjectiveTo study the relationship between maternal asthma and the development of bronchopulmonary dysplasia (BPD).Study DesignUsing a large population-based California cohort, we investigated associations between maternal asthma and preterm birth subtype, as well as maternal asthma and BPD. We used data from 2007-2010 maternal delivery discharge records of 2 009 511 pregnancies and International Classification of Diseases, Ninth Revision codes. Preterm birth was defined as <37 weeks gestational age (GA), with subgroups of <28 weeks, 28-32 weeks, and 33-37 weeks GA, as well as preterm subtype, defined as spontaneous, medically indicated, or unknown. Linkage between the 2 California-wide datasets yielded 21 944 singleton preterm infants linked to their mother's records, allowing estimation of the risk of BPD in mothers with asthma and those without asthma.ResultsMaternal asthma was associated with increased odds (OR, 1.42; 95% CI, 1.38-1.46) of preterm birth at <37 weeks GA, with the greatest risk for 28-32 GA (aOR, 1.60; 95% CI, 1.47-1.74). Among 21 944 preterm infants, we did not observe an elevated risk for BPD in infants born to mothers with asthma (aOR, 1.03; 95% CI, 0.9-1.2). Stratification by maternal treatment with antenatal steroids revealed increased odds of BPD in infants whose mothers had asthma but did not receive antenatal steroids (aOR, 1.54; 95% CI, 1.15-2.06), but not in infants whose mothers had asthma and were treated with antenatal steroids (aOR, 0.85; 95% CI, 0.67-1.07).ConclusionAsthma in mothers who did not receive antenatal steroid treatment is associated with an increased risk of BPD in their preterm infants.Copyright © 2015 Elsevier Inc. All rights reserved.

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