Skip to main content
SpringerLink
Log in

Association of Maternal Asthma and Total Serum Immunoglobulin E levels with Obstetric Complications: The Japan Environment and Children’s Study

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objective

To evaluate the association between maternal asthma (MA) and obstetric complications, while considering subdivided total serum immunoglobulin E (IgE) levels.

Methods

Data of the participants enrolled in the Japan Environment and Children’s Study between 2011 and 2014 were analyzed. In total, 77,131 women with singleton live births at and after 22 weeks of gestation were included. MA was defined based on a self-administered questionnaire. Women with MA were stratified based on the quartile of total serum IgE levels during pregnancy as follows: low IgE levels (< 52.40 IU/mL), moderate IgE levels (52.40–331.00 IU/mL), and high IgE levels (> 331.00 IU/mL). The adjusted odds ratios (aORs) for preterm births (PTB), small for gestational age (SGA) infants, gestational diabetes mellitus, and hypertensive disorders of pregnancy (HDP) were calculated using multivariable logistic regression, while considering women without MA as reference and maternal socioeconomic factors as confounders.

Results

The aORs for SGA infants and HDP in women with MA and high total serum IgE levels were 1.26 (95% confidence interval [CI], 1.05–1.50) and 1.33 (95% CI, 1.06–1.66), respectively. The aOR for SGA infants among women with MA and moderate total serum IgE levels was 0.85 (95% CI, 0.73–0.99). The aOR for PTB among women with MA and low total serum IgE levels was 1.26 (95% CI, 1.04–1.52).

Conclusions for Practice

MA with subdivided total serum IgE levels was associated with obstetric complications. Total serum IgE level may be a potential prognostic marker to predict obstetric complications in pregnancies with MA.

Significance

What is Already Known on this Subject? Maternal asthma (MA) is associated with several obstetric complications, including preterm births (PTB), small for gestational age (SGA) infants, and hypertensive disorders of pregnancy (HDP). Few studies with data from nationwide cohorts have elucidated the association between MA and obstetric complications comprehensively while accounting for the subdivided objective biomarkers of MA.

What this Study Adds? MA with subdivided total serum IgE levels was associated with various obstetric complications. Total serum IgE level may be a potential prognostic marker for pregnant women with MA to predict the potential risk of PTB, SGA infants, and HDP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

The data are unsuitable for deposition in a public repository because of ethical restrictions and the legal framework of Japan. The Act on the Protection of Personal Information (Act No. 57 of May 30, 2003, amendment on September 9, 2015) prohibits public deposition of data containing personal information. Ethical Guidelines for Epidemiological Research enforced by the Japan Ministry of Education, Culture, Sports, Science, and Technology and the Ministry of Health, Labor and Welfare also restrict the open sharing of epidemiological data. All inquiries about access to data should be sent to jecs-en@nies.go.jp. Dr. Shoji F. Nakayama, JECS Programme Office, National Institute for Environmental Studies is responsible for handling enquiries sent to this email address.

Code Availability

Not applicable.

References

  • Brown, M. A., Magee, L. A., Kenny, L. C., Karumanchi, S. A., McCarthy, F. P., Saito, S., et al. (2018). The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertension, 13, 291–310.

    Article  CAS  PubMed  Google Scholar 

  • Burrows, B., Martinez, F. D., Halonen, M., Barbee, R. A., & Cline, M. G. (1989). Association of asthma with serum IgE levels and skin-test reactivity to allergens. The New England Journal of Medicine, 320(5), 271–277.

    Article  CAS  PubMed  Google Scholar 

  • Demissie, K., Breckenridge, M. B., & Rhoads, G. G. (1998). Infant and maternal outcomes in the pregnancies of asthmatic women. American Journal of Respiratory and Critical Care Medicine, 158(4), 1091–1095.

    Article  CAS  PubMed  Google Scholar 

  • Dombrowski, M. P., Schatz, M., Wise, R., Momirova, V., Landon, M., Mabie, W., et al. (2004). Asthma during pregnancy. Obstetrics and Gynecology, 103(1), 5–12.

    Article  PubMed  Google Scholar 

  • El-Shazly, S., Makhseed, M., Azizieh, F., & Raghupathy, R. (2004). Increased expression of pro-inflammatory cytokines in placentas of women undergoing spontaneous preterm delivery or premature rupture of membranes. American Journal of Reproductive Immunology, 52(1), 45–52.

    Article  PubMed  Google Scholar 

  • Hasegawa, T., Koya, T., Sakagami, T., Toyabe, S., Kagamu, H., Arakawa, M., et al. (2012). Asthma control and management changes in Japan: Questionnaire survey. Internal Medicine (tokyo, Japan), 51(6), 567–574.

    Article  PubMed  Google Scholar 

  • Itabashi, K., Miura, F., Uehara, R., & Nakamura, Y. (2014). New Japanese neonatal anthropometric charts for gestational age at birth. Pediatrics International, 56(5), 702–708.

    Article  PubMed  Google Scholar 

  • Jutel, M., & Akdis, C. A. (2011). T-cell subset regulation in atopy. Current Allergy and Asthma Reports, 11(2), 139–145.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kawamoto, T., Nitta, H., Murata, K., Toda, E., Tsukamoto, N., Hasegawa, M., et al. (2014). Rationale and study design of the Japan Environment and Children’s Study (JECS). BMC Public Health, 14(1), 25.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kojima, R., Yokomichi, H., Akiyama, Y., Ooka, T., Miyake, K., Horiuchi, S., et al. (2021). Association between preterm birth and maternal allergy considering IgE level. Pediatrics International, 63(9), 1026–1032.

    Article  CAS  PubMed  Google Scholar 

  • Kyozuka, H., Fujimori, K., Hosoya, M., Yasumura, S., Yokoyama, T., Sato, A., et al. (2018). The Japan Environment and Children’s Study (JECS) in Fukushima Prefecture: Pregnancy outcome after the great East Japan earthquake. The Tohoku Journal of Experimental Medicine, 246(1), 27–33.

    Article  PubMed  Google Scholar 

  • Kyozuka, H., Fujimori, K., Hosoya, M., Yasumura, S., Yokoyama, T., Sato, A., et al. (2019). The effect of maternal age at the first childbirth on gestational age and birth weight: The Japan Environment and Children’s Study (JECS). Journal of Epidemiology, 29(5), 187–191.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meakin, A. S., Saif, Z., Seedat, N., & Clifton, V. L. (2020). The impact of maternal asthma during pregnancy on fetal growth and development: A review. Expert Review of Respiratory Medicine, 14(12), 1207–1216.

    Article  CAS  PubMed  Google Scholar 

  • Mendola, P., Laughon, S. K., Männistö, T. I., Leishear, K., Reddy, U. M., Chen, Z., et al. (2013). Obstetric complications among US women with asthma. American Journal of Obstetrics and Gynecology, 208(2), 127.e1-127.e8.

    Article  PubMed  Google Scholar 

  • Michikawa, T., Nitta, H., Nakayama, S. F., Yamazaki, S., Isobe, T., Tamura, K., et al. (2018). Baseline profile of participants in the Japan Environment and Children’s Study (JECS). Journal of Epidemiology, 28(2), 99–104.

    Article  PubMed  PubMed Central  Google Scholar 

  • Minakami, H., Hiramatsu, Y., Koresawa, M., Fujii, T., Hamada, H., Iitsuka, Y., et al. (2011). Guidelines for obstetrical practice in Japan: Japan society of obstetrics and gynecology (JSOG) and Japan association of obstetricians and gynecologists (JAOG) 2011 edition. The Journal of Obstetrics and Gynaecology Research, 37(9), 1174–1197.

    Article  PubMed  Google Scholar 

  • Murata, T., Kyozuka, H., Yamaguchi, A., Fukuda, T., Yasuda, S., Sato, A., et al. (2021). Maternal pre-pregnancy body mass index and foetal acidosis in vaginal and caesarean deliveries: The Japan environment and children’s study. Scientific Reports, 11(1), 4350.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Murphy, V. E., Namazy, J. A., Powell, H., Schatz, M., Chambers, C., Attia, J., et al. (2011). A meta-analysis of adverse perinatal outcomes in women with asthma. BJOG: an International Journal of Obstetrics & Gynaecology, 118(11), 1314–1323.

    Article  CAS  Google Scholar 

  • Saito, M., Yamamoto-Hanada, K., Pak, K., Ayabe, T., Mezawa, H., Ishitsuka, K., et al. (2018). Having small-for-gestational-age infants was associated with maternal allergic features in the JECS birth cohort. Allergy, 73(9), 1908–1911.

    Article  CAS  PubMed  Google Scholar 

  • Saito-Abe, M., Yamamoto-Hanada, K., Pak, K., Sato, M., Irahara, M., Mezawa, H., et al. (2021). Association of maternal history of allergic features with preterm pregnancy outcomes in the Japan environment and children’s study. International Archives of Allergy and Immunology, 182(7), 650–662.

    Article  PubMed  Google Scholar 

  • Sandberg, M., Frykman, A., Jonsson, Y., Persson, M., Ernerudh, J., Berg, G., et al. (2009). Total and allergen-specific IgE levels during and after pregnancy in relation to maternal allergy. Journal of Reproductive Immunology, 81(1), 82–88.

    Article  CAS  PubMed  Google Scholar 

  • Sears, M. R., Burrows, B., Flannery, E. M., Herbison, G. P., Hewitt, C. J., & Holdaway, M. D. (1991). Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. The New England Journal of Medicine, 325(15), 1067–1071.

    Article  CAS  PubMed  Google Scholar 

  • Spence, T., Allsopp, P. J., Yeates, A. J., Mulhern, M. S., Strain, J. J., & McSorley, E. M. (2021). Maternal serum cytokine concentrations in healthy pregnancy and preeclampsia. Journal of Pregnancy, 2021, 6649608.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yamamoto-Hanada, K., Yang, L., Ishitsuka, K., Ayabe, T., Mezawa, H., Konishi, M., et al. (2017). Allergic profiles of mothers and fathers in the Japan environment and children’s study (JECS): A nationwide birth cohort study. The World Allergy Organization Journal, 10(1), 24.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yokoyama, Y., Takachi, R., Ishihara, J., Ishii, Y., Sasazuki, S., Sawada, N., et al. (2016). Validity of short and long self-administered food frequency questionnaires in ranking dietary intake in middle-aged and elderly Japanese in the Japan public health center-based prospective study for the next generation (JPHC-NEXT) protocol area. Journal of Epidemiology, 26(8), 420–432.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to all participants of the study. Members of the JECS Group as of 2021 are: Michihiro Kamijima (principal investigator, Nagoya City University, Nagoya, Japan), Shin Yamazaki (National Institute for Environmental Studies, Tsukuba, Japan), Yukihiro Ohya (National Center for Child Health and Development, Tokyo, Japan), Reiko Kishi (Hokkaido University, Sapporo, Japan), Nobuo Yaegashi (Tohoku University, Sendai, Japan), Koichi Hashimoto (Fukushima Medical University, Fukushima, Japan), Chisato Mori (Chiba University, Chiba, Japan), Shuichi Ito (Yokohama City University, Yokohama, Japan), Zentaro Yamagata (University of Yamanashi, Chuo, Japan), Hidekuni Inadera (University of Toyama, Toyama, Japan), Takeo Nakayama (Kyoto University, Kyoto, Japan), Hiroyasu Iso (Osaka University, Suita, Japan), Masayuki Shima (Hyogo College of Medicine, Nishinomiya, Japan), Youichi Kurozawa (Tottori University, Yonago, Japan), Narufumi Suganuma (Kochi University, Nankoku, Japan), Koichi Kusuhara (University of Occupational and Environmental Health, Kitakyushu, Japan), and Takahiko Katoh (Kumamoto University, Kumamoto, Japan).

Funding

The Japan Environment and Children’s Study was funded by the Ministry of the Environment, Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the Ministry of the Environment, Japan. The funding source had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. Fukushima Regional Center for the Japan Environment and Children’s Study, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Tsuyoshi Murata, Hyo Kyozuka, Toma Fukuda, Shun Yasuda, Akiko Yamaguchi, Akiko Sato, Yuka Ogata, Kosei Shinoki, Mitsuaki Hosoya, Seiji Yasumura, Koichi Hashimoto, Hidekazu Nishigori & Keiya Fujimori

  2. Department of Obstetrics and Gynecology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Tsuyoshi Murata, Hyo Kyozuka, Toma Fukuda, Shun Yasuda, Akiko Yamaguchi & Keiya Fujimori

  3. Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Mitsuaki Hosoya & Koichi Hashimoto

  4. Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Seiji Yasumura

  5. Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Hidekazu Nishigori

Authors
  1. Tsuyoshi Murata
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hyo Kyozuka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Toma Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shun Yasuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akiko Yamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akiko Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yuka Ogata
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kosei Shinoki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mitsuaki Hosoya
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Seiji Yasumura
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Koichi Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Hidekazu Nishigori
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Keiya Fujimori
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

and the Japan Environment and Children’s Study (JECS) Group

Contributions

TM conceptualized and designed the study. HK, TF, SY, AY, KH, HN, and KF contributed to study design. KS, AS, and YO collected the data. TM analyzed the data and wrote the manuscript. MH, SY, KH, KS, AS, YO, HN, KF, and the JECS group reviewed the manuscript and provided critical advice. All authors approved the final manuscript.

Corresponding author

Correspondence to Tsuyoshi Murata.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The JECS protocol was reviewed and approved by the Ministry of the Environment’s Institutional Review Board on Epidemiological Studies on September 10, 2010 (approval No. 100910001) and by the ethics committees of all participating institutions.

Consent to Participate

Written informed consent was obtained from all participants.

Consent for Publication

Written informed consent was obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murata, T., Kyozuka, H., Fukuda, T. et al. Association of Maternal Asthma and Total Serum Immunoglobulin E levels with Obstetric Complications: The Japan Environment and Children’s Study. Matern Child Health J 27, 1229–1237 (2023). https://doi.org/10.1007/s10995-023-03647-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-023-03647-y

Keywords

Search

Navigation