@article{d12a7c905a7747f8aebd0428f36a4dc7,
title = "The Association of Maternal Asthma and Early Pregnancy Vitamin D with Risk of Preeclampsia: An Observation From Vitamin D Antenatal Asthma Reduction Trial (VDAART)",
abstract = " Background: Maternal asthma, uncontrolled asthma, and low vitamin D levels during pregnancy have been individually linked to increased risk of preeclampsia. Objective: To investigate the association of history of physician-diagnosed asthma and uncontrolled asthma status during pregnancy with the risk of preeclampsia and the effects of early pregnancy vitamin D concentrations on this relationship. Methods: A total of 816 subjects with available pregnancy outcome data and risk factors of interest were analyzed. A group of experienced obstetricians and gynecologists from 3 study centers validated the preeclampsia diagnoses. Vitamin D was measured using the DiaSorin method at 10 to 18 weeks of gestation. The Pregnancy-Asthma Control Test was used to assess asthma control during pregnancy. Criterion-based stepwise variable selection algorithm was applied to investigate the relationships of risk factors of interest (history of asthma diagnosis, uncontrolled asthma during pregnancy, and vitamin D) to preeclampsia. Results: The incidence of preeclampsia was not related to the presence of asthma diagnosis (8.9% with vs 7.4% without). The adjusted odds of preeclampsia controlled for maternal serum 25-hydroxyvitamin D (25OHD) concentrations was higher for women with a higher proportion of uncontrolled asthma months per visit during pregnancy (adjusted odds ratio, 3.55; 95% CI, 1.15-13.0). Adjusting for asthma control status during pregnancy, an additional decrease in the associated preeclampsia risk by 7% was observed for a 10-unit (ng/mL) increase in early pregnancy 25OHD levels (adjusted odds ratio 10-unit , 0.60; 95% CI, 0.43-0.82) as compared with the previous risk estimate of preeclampsia associated with low maternal 25OHD unadjusted for asthma control status. Conclusions: Uncontrolled asthma during pregnancy is associated with an increased risk of preeclampsia. Early pregnancy 25OHD contributes to the association of uncontrolled asthma status with preeclampsia.",
keywords = "25OHD, Asthma, Exacerbation, Preeclampsia, Pregnancy, Vitamin D",
author = "Hooman Mirzakhani and Carey, {Vincent J.} and McElrath, {Thomas F.} and Nancy Laranjo and George O'Connor and Iverson, {Ronald E.} and Aviva Lee-Parritz and Strunk, {Robert C.} and Bacharier, {Leonard B.} and Macones, {George A.} and Zeiger, {Robert S.} and Michael Schatz and Hollis, {Bruce W.} and Litonjua, {Augusto A.} and Weiss, {Scott T.}",
note = "Funding Information: The Vitamin D Antenatal Asthma Reduction Trial was supported by the National Heart, Lung, and Blood Institute (NHLBI) (grant no. U01HL091528) and National Research Service Award T32-HL007427. Additional support was provided by the National Centers for Advancing Translational Sciences for participant visits at Boston Medical Center (grant no. U54TR001012). The NHLBI monitored the conduct of the trial and selected the membership of the Data and Safety Monitoring Board (DSMB). All communication between the investigators and the DSMB coursed through the staff of the NHLBI. All manuscripts, including this current one, during the trial are presented to the DSMB for approval before submission for peer review. The NHLBI had no role in the design and the conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript, other than what pertained to the DSMB. Funding Information: Conflicts of interest: H. Mirzakhani, V. J. Carey, N. Laranjo, G. A. Macones, M. Schatz, and B. W. Hollis have received research support from the National Institutes of Health (NIH). T. F. McElrath has received consultancy fees from NxPrenatal. G. O'Connor has received research support from the NIH and Jennsen Pharmaceuticals and has received consultancy fees from AstraZeneca. L. B. Bacharier has received research support from the NIH/the National Heart, Lung, and Blood Institute (NHLBI); has received consultancy and lecture fees from Aerocrine, GlaxoSmithKline, Genentech/Novartis, Teva, and Boehringer Ingelheim; has received lecture fees from and is on the scientific advisory board for Merck; has received consultancy fees from Cephalon; is on the DBV Technologies Data Safety Monitoring Board; has received lecture fees from AstraZeneca; has received honoraria for CME program development from WedMD/Medscape; and is on the advisory boards for Sanofi, Vectura, and Circassia. R. S. Zeiger has received research support from the NHLBI. A. A. Litonjua has received research support from the NIH; has received consultancy fees from AstraZeneca, LP; and receives royalties from UpToDate. The rest of the authors declare that they have no relevant conflicts of interest. Funding Information: The Vitamin D Antenatal Asthma Reduction Trial was supported by the National Heart, Lung, and Blood Institute (NHLBI) (grant no. U01HL091528 ) and National Research Service Award T32-HL007427. Additional support was provided by the National Centers for Advancing Translational Sciences for participant visits at Boston Medical Center (grant no. U54TR001012 ). The NHLBI monitored the conduct of the trial and selected the membership of the Data and Safety Monitoring Board (DSMB). All communication between the investigators and the DSMB coursed through the staff of the NHLBI. All manuscripts, including this current one, during the trial are presented to the DSMB for approval before submission for peer review. The NHLBI had no role in the design and the conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript, other than what pertained to the DSMB. Publisher Copyright: {\textcopyright} 2017 American Academy of Allergy, Asthma & Immunology",
year = "2018",
month = mar,
doi = "10.1016/j.jaip.2017.07.018",
language = "English",
volume = "6",
pages = "600--608.e2",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
number = "2",
}