Evidence map›Paper›PMID 41721292›Full record

ArticleBMC medicine2026

Prenatal exposure to maternal asthma and asthma medication and neurodevelopmental outcomes: a population cohort study of 179,024 children.

Lama A Shakhshir, Sarjit Singh, Jill P Pell, Scott M Nelson, Daniel F Mackay, Claire E Hastie, Logesh R Sivakumar, Michael Fleming

Abstract read
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In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lama A ShakhshirSchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK. l.shakhshir.1@research.gla.ac.uk.
Sarjit SinghSchool of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Jill P PellSchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
Scott M NelsonSchool of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
Daniel F MackaySchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
Claire E HastieSchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
Logesh R SivakumarSchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.
Michael FlemingSchool of Health and Wellbeing, University of Glasgow, Clarice Pears Building, 90 Byres Road, Glasgow, G12 8TB, UK.

Funding

Health Data Research UK MR/S003800/1
6 · The paper itself

Abstract

backgroundAsthma exacerbations during pregnancy can adversely affect maternal and foetal health. However, prenatal exposure to asthma medication may itself impact child outcomes. This study aims to determine whether prenatal exposure to asthma medication was associated with a range of neurodevelopmental outcomes.

methodsA birth cohort was constructed using linked health and education records of children liveborn in Wales from 2009 to 2016, with up to 12 years follow-up. Generalized estimating equations with a binomial distribution and logit link function were employed to evaluate special educational need (SEN) and its causes, including autism spectrum disorder (ASD), communication problems, behavioural, emotional, and social difficulties, learning difficulties, physical and medical difficulties, and sensory impairment. Cox proportional hazard models were used to investigate attention deficit hyperactivity disorder (ADHD).

resultsOf the 179,024 offspring, 11,991 (6.7%) had mothers with treated asthma, 4927 (2.8%) had mothers with untreated asthma, and 5265 (2.9%) had mothers who took asthma medication without a record of asthma. SEN was recorded in 50,955 (28.5%) children. Risk of overall SEN and ADHD was higher following prenatal exposure to short-acting beta-agonists (SABA) and inhaled corticosteroids (ICS) but also higher in the offspring of mothers with untreated asthma (SEN aOR 1.14, 95% CI 1.07-1.23; ADHD aHR 1.70, 95% CI 1.42-2.05). ASD was associated with treated, but not untreated, asthma and the association with prenatal medication was specific to SABA as mono- or polytherapy (aOR 1.20, 95% CI 1.05-1.37). However, a direct comparison of treated with untreated asthma was not statistically significant.

conclusionsThe non-specific associations with overall SEN and ADHD are likely to reflect their associations with asthma and confounding by indication/severity. The associations with ASD may reflect a treatment effect of SABA or confounding by severity. Further studies are needed to confirm or refute the former, to support evidence-based asthma management during pregnancy.

Indexed as

Anti-Asthmatic AgentsAsthmaNeurodevelopmental DisordersPregnancy ComplicationsPrenatal Exposure Delayed EffectsAdultAttention Deficit Disorder with HyperactivityAutism Spectrum DisorderBirth CohortChildChild, PreschoolCohort StudiesFemaleHumansInfantMaleAnti-Asthmatic AgentsAnti-asthmatic medicationAsthmaAttention deficit disorder with hyperactivityAutism spectrum disorderIn-utero exposureLearning disordersSpecial educational need

Identifiers

PMID41721292
PMCPMC13032591

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.