Table 1_Maternal hypertensive disorders during pregnancy and their link to childhood asthma: a systematic review and meta-analysis.docx

ObjectiveThe association between Hypertensive Disorders of Pregnancy (HDP) and childhood asthma remains controversial, with limited systematic synthesis. This study aimed to integrate global observational evidence to evaluate the relationship between HDP [and its subtypes, pre-eclampsia (PE) and gestational hypertension (GH)] and offspring asthma risk, while exploring sources of heterogeneity.
MethodsFollowing PRISMA 2020 and MOOSE guidelines, 20 observational studies (n = 9,447,593) were identified via systematic searches in Cochrane Library, PubMed, Web of Science, and ScienceDirect (up to January 2025). Random-effects meta-analysis pooled odds ratios (ORs), with subgroup analyses for HDP subtypes, geographic regions, and offspring age. Quality was assessed using the modified Newcastle-Ottawa Scale (mNOS) for cohorts and AHRQ checklist for cross-sectional studies.
ResultsHDP exposure significantly increased childhood asthma risk (pooled OR = 1.20, 95% CI = 1.14–1.26, P < 0.00001). PE was associated with asthma (OR = 1.20, 95% CI = 1.13–1.27), but GH was not (OR = 1.15, 95% CI = 0.99–1.32). Stratified analyses revealed increased risk in European (OR = 1.20) and North American (OR = 1.62) populations, and in infants (0–2 years, OR = 1.27) and school-aged children (7–12 years, OR = 1.22), but not in Asian populations or 2–6-year-olds. Sensitivity analyses confirmed result robustness.
ConclusionHDP (particularly PE) exposure is significantly associated with increased offspring asthma risk, with age- and region-specific heterogeneity. Future multicenter cohorts should validate causality and explore subtype-specific mechanisms and interventions for early asthma prevention.
Systematic Review RegistrationPROSPERO 2025 CRD420251052620.

**研究目的**：妊娠高血压疾病（Hypertensive Disorders of Pregnancy, HDP）与儿童哮喘之间的关联尚存争议，且相关系统整合研究较为匮乏。本研究旨在整合全球观察性研究证据，评估HDP[及其亚型：先兆子痫（pre-eclampsia, PE）和妊娠期高血压（gestational hypertension, GH）]与子代哮喘风险的关联，并探索异质性来源。

**研究方法**：本研究遵循PRISMA 2020（系统评价与荟萃分析优先报告条目2020版）及MOOSE（流行病学观察性研究荟萃分析指南）规范，通过在Cochrane图书馆、PubMed、Web of Science及ScienceDirect数据库进行系统检索（检索截止至2025年1月），最终纳入20项观察性研究，合计样本量9,447,593例。采用随机效应模型开展荟萃分析，合并比值比（odds ratios, OR），并针对HDP亚型、地理区域及子代年龄开展亚组分析。质量评价方面，队列研究采用改良纽卡斯尔-渥太华量表（modified Newcastle-Ottawa Scale, mNOS），横断面研究采用美国医疗保健研究与质量局（Agency for Healthcare Research and Quality, AHRQ）检查表。

**研究结果**：妊娠高血压疾病暴露可显著升高儿童哮喘风险（合并OR=1.20，95%置信区间（confidence interval, CI）=1.14~1.26，P<0.00001）。其中先兆子痫与哮喘风险升高相关（OR=1.20，95%CI=1.13~1.27），但妊娠期高血压与哮喘风险无显著关联（OR=1.15，95%CI=0.99~1.32）。分层分析显示，欧洲人群（OR=1.20）、北美人群（OR=1.62）、婴儿期（0~2岁，OR=1.27）及学龄期儿童（7~12岁，OR=1.22）的哮喘风险显著升高，但亚洲人群及2~6岁儿童未观察到该关联。敏感性分析证实本研究结果具有稳健性。

**研究结论**：妊娠高血压疾病（尤其是先兆子痫）暴露与子代哮喘风险升高显著相关，且该关联存在年龄及区域特异性异质性。未来应开展多中心队列研究以验证其因果关联，并探索亚型特异性机制及哮喘早期预防干预手段。

**系统评价注册信息**：PROSPERO 2025 CRD420251052620。