Effect of fractional exhaled nitric oxide (FENO)-based asthma management during pregnancy versus usual care on infant development, temperament, sensory function and autism signs

• Published in: European journal of pediatrics 2024-08, Vol.183 (8), p.3199-3210
• Main Authors: Whalen, Olivia M., Campbell, Linda E., Lane, Alison E., Karayanidis, Frini, Mallise, Carly A., Woolard, Alix J., Holliday, Elizabeth G., Mattes, Joerg, Collison, Adam, Gibson, Peter G., Murphy, Vanessa E.
• Format: Article
• Language: English
• Subjects: Adult; Asthma; Asthma - therapy; Autism; Autistic Disorder; Babies; Child Development - physiology; Emotional behavior; Female; Follow-Up Studies; Fractional Exhaled Nitric Oxide Testing - methods; Humans; Infant; Infants; Intellectual disabilities; Male; Management; Medicine; Medicine & Public Health; Motor task performance; Nitric oxide; Nitric Oxide - analysis; Nitric Oxide - metabolism; Offspring; Pediatrics; Pregnancy; Pregnancy Complications - psychology; Pregnancy Complications - therapy; Prenatal Exposure Delayed Effects; Social behavior; Temperament
• ISSN: 1432-1076; 0340-6199; 1432-1076
• DOI: 10.1007/s00431-024-05578-4

Asthma during pregnancy is associated with a range of adverse perinatal outcomes. It is also linked to increased rates of neurodevelopmental conditions in the offspring. We aimed to assess whether fractional exhaled nitric oxide ( F ENO )-based asthma management during pregnancy improves child developmental and behavioural outcomes compared to usual care. The Breathing for Life Trial was a randomised controlled trial that compared F ENO -based asthma management during pregnancy to usual care. Participants were invited to the developmental follow-up, the Breathing for Life Trial – Infant Development study, which followed up infants at 6 weeks, 6 months and 12 months. The primary outcomes were measured in infants at 12 months using the Bayley-III: Cognitive, Language and Motor composite scores. Secondary outcomes included Bayley-III social-emotional and adaptive behaviour scores, autism likelihood and sensory and temperament outcomes. The exposure of interest was the randomised intervention group. Two hundred and twenty-two infants and their 217 participating mothers were recruited to the follow-up; 107 mothers were in the intervention group and 113 were in the control group. There was no evidence of an intervention effect for the primary outcomes: Bayley-III cognitive (mean = 108.9 control, 108.5 intervention, p  = 0.93), language (mean = 95.9 control, 95.6 intervention, p  = 0.87) and motor composite scores (mean = 97.2 control, 97.9 intervention, p  = 0.25). Mean scores for secondary outcomes were also similar among infants born to control and F ENO group mothers, with few results reaching p