{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T19:34:15Z","timestamp":1761766455384,"version":"3.40.5"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2019,1,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic respiratory diseases and use of antiasthmatic medication during pregnancy may both play a role in the etiology of congenital anorectal malformations (ARM). However, it is unclear, whether the medication use or the underlying condition would be responsible. Therefore, our aim was to unravel the role of maternal chronic respiratory diseases from that of antiasthmatic medication in the etiology of ARM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We obtained 412 ARM patients and 2,137 population\u2010based controls from the Dutch AGORA data\u2010 and biobank. We used maternal questionnaires and follow\u2010up telephone interviews to obtain information on chronic respiratory diseases, antiasthmatic medication use, and potential confounders. Multivariable logistic regression analyses were performed to estimate odds ratios (ORs) with 95% confidence intervals (95% CI).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We observed higher risk estimates among women with chronic respiratory diseases with and without medication use (1.4 [0.8\u20132.7] and 2.0 [0.8\u20135.0]), both in comparison to women without a chronic respiratory disease and without medication use. Furthermore, increased ORs of ARM were found for women using rescue medication (2.4 [0.8\u20137.3]) or a combination of maintenance and rescue medication (2.5 [0.9\u20136.7]). In addition, increased risk estimates were observed for women having nonallergic triggers (2.5 [1.0\u20136.3]) or experiencing exacerbations during the periconceptional period (3.5 [1.4\u20138.6]).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Although the 95% CIs of most associations include the null value, the risk estimates all point towards an association between uncontrolled chronic respiratory disease, instead of antiasthmatic medication use, with ARM in offspring. Further in\u2010depth studies towards mechanisms of this newly identified risk factor are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.1429","type":"journal-article","created":{"date-parts":[[2018,12,20]],"date-time":"2018-12-20T05:09:18Z","timestamp":1545282558000},"page":"62-69","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Uncontrolled maternal chronic respiratory diseases in pregnancy: A new potential risk factor suggested to be associated with anorectal malformations in offspring"],"prefix":"10.1002","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0977-2771","authenticated-orcid":false,"given":"Romy","family":"van de Putte","sequence":"first","affiliation":[{"name":"Department for Health Evidence Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc)  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivo","family":"de Blaauw","sequence":"additional","affiliation":[{"name":"Department of Surgery\u2014Paediatric surgery Radboudumc Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rianne","family":"Boenink","sequence":"additional","affiliation":[{"name":"Department for Health Evidence Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc)  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monique H.E.","family":"Reijers","sequence":"additional","affiliation":[{"name":"Department Dekkerswald Radboudumc  The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.A.","family":"Broens","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery University of Groningen, University Medical Center Groningen  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelius E.J.","family":"Sloots","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Sophia Children's Hospital, Erasmus Medical Center  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arno F.J.","family":"van Heijst","sequence":"additional","affiliation":[{"name":"Department of Pediatrics\u2014Neonatology Radboudumc Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleen M.H.J.","family":"van Gelder","sequence":"additional","affiliation":[{"name":"Department for Health Evidence Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc)  Nijmegen The Netherlands"},{"name":"REshape Innovation Center Radboudumc  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nel","family":"Roeleveld","sequence":"additional","affiliation":[{"name":"Department for Health Evidence Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc)  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iris A.L.M.","family":"van Rooij","sequence":"additional","affiliation":[{"name":"Department for Health Evidence Radboud Institute for Health Sciences, Radboud university medical center (Radboudumc)  Nijmegen The Netherlands"},{"name":"Department of Surgery\u2014Paediatric surgery Radboudumc Amalia Children's Hospital  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.07.022"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2006.062950"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2008.02.038"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.20651"},{"key":"e_1_2_7_6_1","unstructured":"CBS. 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