MAESTRO - Maternal Asthma Events, STRess and Offspring

In the MAESTRO study we are interested to understand the factors related to the health of mothers with and without asthma during their pregnancy, delivery and in the postpartum period.

In total 1693 women were recruited the MAESTRO-study in the years 2013-2019. Questionnaires and saliva samples were collected from the women in early pregnancy (pregnancy week 8-12), towards the end of the pregnancy (pregnancy week 28-32) and 6 months after delivery.  Data was collected from the women’s medical notes and the sonography results from the antenatal/midwife clinic and from delivery. We also measured lung function using spirometry in 250 study participants during and after their pregnancy. More information can be found in our recent publications.

In the MAESTRO-CHILD study we are following up the children born to the mothers who participated in the MAESTRO-study.

Background and aims

Asthma is one of the most common chronic respiratory diseases in children and adults and is also prevalent among pregnant women. Knowledge surrounding how asthma impacts the pregnancy and offspring is lacking. Some studies suggest that stress during pregnancy effects pregnancy and delivery outcomes and increases the risk that the child develops asthma. The knowledge gained from this research is pivotal to allow for prevention. The aim with the MAESTRO-study is to understand how mothers with different levels of stress and asthma influences their pregnancy and delivery.  These women are then compared with women without asthma. We are interested to understand factors which contribute to the development of asthma, amount of asthma medication used during the pregnancy and if there is an association between stress levels and other factors in the environment.

Asthma in the mother and other factors during pregnancy and delivery (diet, infections, anxiety and environmental factors) can also be associated with the development of common diseases in the child. We are interested to study these factors and follow the woman during her pregnancy and the subsequent offspring and family after delivery and into childhood.

MAESTRO-study – data collection is complete. Analyses are ongoing and articles will be published in due course.

MAESTRO-CHILD 3-year follow up.

The children in the MAESTRO-CHILD study were recruited by contacting the mothers who had participated in the MAESTRO study. Parents/guardians who wanted their child to participate in the study received a questionnaire when the child was 3 years old. The parents were asked to answer questions regarding the child´s health since birth including breastfeeding, diet and environmental factors as well as which infections the children had had and which, if any, of the common childhood diseases the children had developed. We also asked questions regarding background factors in the parents and in the family (for example parental education).  Parents/guardians were asked for written consent for their child to be part of the study and to link the collected data to our national health registers.

Those parents/guardians who chose for their children to participate in the MAESTRO-CHILD study also received a test kit in the post for saliva samples which parents/guardians collected from their children and sent back to us. The saliva samples were tested for cortisol levels which is a measure of stress. In total we recruited 550 children to the MAESTRO-CHILD 3 year follow up.

MAESTRO-CHILD 8-year follow-up

We are now planning an 8 year follow-up of the children. The parents/guardians and children who participated in the 3 year follow-up will receive a questionnaire. They will be asked to answer questions on the child’s health since the 3 year follow-up, infections, diet and environmental factors as well as which if any of the common childhood diseases the children have developed. 

Those who choose to continue to participate in the study will again receive a test kit in the post for saliva samples which parents/guardians will collect from their children and send back to us. The saliva sample will be tested for cortisol levels which is a measure of stress. We will also ask a number of children to come for a health check-up where we will measure length, weight, lung function and take blood and faecal samples.

Contact information

Postal address
Karolinska Institutet
Box 281
17177 Stockholm

Contact persons

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Catarina Almqvist Malmros

Professor, project leader
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Hanna Karim

Phd Student
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Samuel Arthur Rhedin

Postdoctoral Studies
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Aki Tuuliainen

System Developer

Publications from the MAESTRO-study

Maternal asthma and early fetal growth, the MAESTRO study.
Rejnö G, Lundholm C, Saltvedt S, Larsson K, Almqvist C
Clin Exp Allergy 2021 07;51(7):883-891

Associations Between Maternal Distress, Cortisol Levels, and Perinatal Outcomes.
Lundholm C, Rejnö G, Brew B, Smew AI, Saltvedt S, Almqvist C
Psychosom Med 2022 04;84(3):288-296

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