Contribution of prenatal factors and in formation of asthma phenotypes in children (part I)

Cover Page
Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access


Results of the prospective study conducted to assess the perinatal risk factors contribution in the asthma phenotypes formation in childhood are presented. Of 712 children, which have been observed from the first wheezing onset in St Petersburg’s state ambulances, 238 children with bronchial asthma developed in later years of life were included in random sample. Bronchial asthma proceeded in the structure of atopic disease in 128 children (phenotype ABA), and as the part of the limited allergic lesion of respiratory tract - in 110 children (phenotype RBA). It was found that bronchial asthma in mother, especially mother’s asthma with the early age onset, pregnancy pathology and maternal Smoking during pregnancy are the most significant risk factors which contribute in formation of ABA asthma phenotype. Maternal Smoking during pregnancy increased the frequency of severe asthma with ABA phenotype in the offspring during next years of their life. Clinically, the ABA phenotype is characterized by more frequent debut at the age of 1 year and usually diagnosed before 7 years of age, the presence of food sensitization in 70-90 % of cases, and a high level of hyperimmunoglobulinemia E. Such triggers as the Cesarean delivery, absence of the breastfeeding and exposure to tobacco products in the first years of life are the most significant risk factors in formation of the RBA asthma phenotype. The absence of allergic diseases in both parents or allergic ллерголог in mothers, later age debut and diagnosis of asthma, extremely low frequency of food sensibilization (less than 15 %), high frequency of hyperresponsivity, and low frequency of hyperimmunoglobulinemia E, exceeds the norm in 2 times are the typical features of RBA asthma phenotype.

Full Text

Restricted Access

About the authors

Liudmila A Zhelenina

St Petersburg State Pediatric Medical University of Ministry of Health of the Russian Federation

MD, PhD, Dr Med Sci, Professor, Head. Department of Pediatrics, Endocrinology and Abilitologii AF and DPO

Anna N Galustyan

St Petersburg State Pediatric Medical University of Ministry of Health of the Russian Federation

MD, PhD, Associate Professor, Department of Allergology and Clinical immunology AF and DPO

Natalya B Platonova

Institute of Experimental Medicine

post-graduate student of the Department of Ecological Physiology

Mariya V Kuropatenko

Institute of Experimental Medicine

MD, PhD, Associate Professor, Senior Researcher of the Department of Ecological Physiology


  1. Аллергология. Федеральные клинические рекомендации. Главные редакторы: акад. РАН Р.М. Хаитов, проф. Н.И. Ильина. - М.: Фармарус Принт Медиа, 2014. [Allergology. Federal clinical recommendations. Editors: Acad RAS RM Khaitov, prof. NI Ilyin. Moscow: Farmarus Print Media; 2014. (In Russ).]
  2. Беляева Л.М., Панулина Н.И., Микульчик Н.В. Атопическая болезнь у детей: возрастная эволюция, роль неинфекционных и инфекционных факторов в ее формировании. Инфекционные аспекты соматической патологии у детей: сб. аннотир. докл. III Всерос. науч.-практ. конф. - М., 2010. - С. 18-21 [Belyaeva LM, Panulina NI, Mikul’chik NV. Atopicheskaya bolezn’ u detey: vozrastnaya evolyutsiya, rol’ neinfektsionnykh i infektsionnykh faktorov v ee formirovanii. Infektsionnye aspekty somaticheskoy patologii u detey. (Conference proceedigs). Moscow; 2010; 18-21 (In Russ).]
  3. Вахарловская М.В., Петрова М.А., Лаврова О.В., и др. Состояние здоровья и некоторые генотипические особенности детей, родившихся у матерей с бронхиальной астмой // Медицинский академический журнал. - 2013. - Т. 13. - № 2. - С. 59-63. [Vakharlovskaya MV, Petrova MA, Lavrova OV, et al. Health and some genotypic characteristics of children born to mothers with asthma. Meditsinskiy akademicheskiy zhurnal. 2013;13(2):59-63 (In Russ).]
  4. Глобальная стратегия лечения и профилактики бронхиальной астмы (пересмотр 2014 г.) / Пер. с англ.; под ред. А.С. Белевского. - М.: Российское респираторное общество, 2015. - 148 с., ил. [Global’naya strategiya lecheniya i profilaktiki bronkhial’noy astmy (peresmotr 2014 g.). Ed by A.S. Belevskiy. Moscow: Rossiyskoe respiratornoe obshchestvo; 2015;148. (In Russ).]
  5. Национальная программа «Бронхиальная астма у детей. Стратегия лечения и профилактика». - 4-е изд. - М., 2012. [Natsional’naya programma “Bronkhial’naya astma u detey. Strategiya lecheniya i profilaktika”. 4th ed. Moscow; 2012. (In Russ).]
  6. Ненашева Н.М. Фенотипы бронхиальной астмы и выбор терапии // Практическая пульмонология. - 2014. - Т. 2. - № 2. - С. 11. [Nenasheva NM. Asthma phenotypes and the choice of therapy. Prakticheskaya pul’monologiya. 2014;2(2):11. (In Russ).]
  7. Aagaard K, Ma J, Antony K.M, et al. The placenta harbors a unique microbiome. Sci Transl Med. 2014;6:237-65. doi: 10.1126/scitranslmed.3008599.
  8. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. Burney PG [added]; Johnston SL [added]; Warner JO [added]. J Allergy Clin Immunol. 2012;130(5):1049-62. doi: 10.1016/j.jaci.2012.07.053.
  9. Banderali G, Martelli A, Landi M, et al. Short and long term health effects of parental tobacco smoking during pregnancy and lactation: a descriptive review. J Transl Med. 2015;13:327-34. doi: 10.1186/s12967-015-0690-y.
  10. Burke H, Leonardi-Bee J, Hashim A, et al. Prenatal and Passive Smoke Exposure and Incidence of Asthma and Wheeze: Systematic Review and Meta-analysis. Pediatrics. 2012;129(4):735-45. doi: 10.1542/peds.2011-2196.
  11. Chih-Chiang, Rong-Fu Chen, Ho-Chang Kuo. Different Implications of Paternal and Maternal Atopy for Perinatal IgE Production and Asthma Development. Clinical and Developmental Immunology. 2012;2012:132-42.
  12. Cook-Mills Joan M. Maternal Influences over Offspring Allergic Responses. Curr Allergy Asthma Rep. 2015;15(2):501-18. doi: 10.1007/s11882-014-0501-1.
  13. Cuppari C, Manti S, Salpietro A, et al. Mode of delivery and risk for development of atopic diseases in children. Allergy Asthma Proc. 2015;36(5):344-51. doi: 10.2500/aap.2015.36.3870.
  14. Dotterud CK, Storrø O, Simpson MR, et al. The impact of pre- and postnatal exposures on allergy related diseases in childhood: a controlled multicentre intervention study in primary health care. BMC Public Health. 2013;13:123. doi: 10.1186/1471-2458-13-123.
  15. Garden FL, Simpson JM, Mellis CM, et al. Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis. Eur Respir J. 2016;47(1):499-509. doi: 10.1183/13993003.00284-2015.
  16. Guilbert TW, Mauger DT, Lemanske RF Jr. Childhood asthma-predictive phenotype. J Allergy Clin Immunol Pract. 2014;2(6):664-70. doi: 10.1016/j.jaip.2014.09.010.
  17. Hartwig IR, Sly PD, Schmidt LA, et al. Prenatal adverse life events increase the risk for atopic diseases in children, which is enhanced in the absence of a maternal atopic predisposition. J Allergy Clin Immunol. 2014;134(1):160-9. doi: 10.1016/j.jaci.2014.01.033.
  18. Havstad S, Johnson CC, Kim H, et al. Atopic phenotypes identified with latent class analyses at age 2 years. J Allergy Clin Im. 2014;134(3):722-7.
  19. Hovland V, Riiser A, Mowinckel P, et al. Early risk factors for pubertal asthma. Clin Exp Allergy. 2015;45(1): 164-76. doi: 10.1111/cea.12409.
  20. Huang L, Chen Q, Zhao Y, et al. Is elective cesarean section associated with a higher risk of asthma? A meta-analysis. J Asthma. 2015;52(1):16-25. doi: 10.3109/02770903.2014.952435.
  21. Kristensen K, Henriksen L. Cesarean section and disease associated with immune function. J Allergy Clin Immunol. 2016;137(2):587-90. doi: 10.1016/j.jaci.2015.07.040.
  22. Lasso-Pirot A, Delgado-Villalta S, Spanier AJ. Early childhood wheezers: identifying asthma in later life. J of Asthma and Allergy. 2015;8:63-73.
  23. Paaso EMS, Jaakkola MS, Rantala AK, et al. Allergic diseases and asthma in the family predict the persistence and onset-age of asthma: a prospective cohort study. Respiratory Research. 2014;15:152-61. doi: 10.1186/s12931-014-0152-8.



Abstract - 1604

PDF (Russian) - 297


Article Metrics

Metrics Loading ...



Copyright (c) 2016 Zhelenina L.A., Galustyan A.N., Platonova N.B., Kuropatenko M.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies