Perinatal events in the development of asthma

Many potential factors are likely involved in the pathogenesis of asthma. These include prenatal, peripartum, and postnatal influences. Prenatally, genetic endowment, maternal smoking, in utero allergen sensitization, and alterations in maternal immune function, especially at the placental level, may increase the risk for asthma and atopy. In the peripartum period, suspected factors include obstetric practices (eg, the use of prostaglandins, hormones, and other agents) and prematurity. Postnatally passive smoke exposure, neonatal or early childhood infections and breast-feeding are under increasing scrutiny as to their possible role in the development of asthma. Despite the volumes of work already reported, much more is left to be done to sort out the complex interrelationships of these and other as yet unsuspected influences on the development of asthma.