Non-allergic Factors That Influence Asthma Control in Pregnancy

Overview

Journal Eur J Midwifery

Date 2024 Aug 29

PMID 39206325

Authors

Agnieszka Rey

Marta Chelminska

Iwona Damps-Konstanska

Affiliations

Soon will be listed here.

Abstract

Introduction: Numerous factors may influence the asthma course during pregnancy, potentially elevating the risk of specific pregnancy complications. This study aimed to evaluate non-allergic factors influencing asthma and to assess perinatal outcomes between asthmatic and non-asthmatic pregnancies in the population of the Pomeranian Voivodeship region of Poland.

Methods: The mixed cohort study was performed with 83 pregnant asthmatic patients aged 18-38 years. The control group consisted of 83 patients without asthma diagnosis or symptoms. A specially designed questionnaire was used to evaluate asthma course and perinatal outcomes. An Asthma Control Test (ACT) adapted for pregnancy was performed on enrollment. Asthma severity was assessed according to GINA guidelines.

Results: In 19 cases (22.80%), patients quit their regular treatment after pregnancy was confirmed. Respiratory tract infection occurred in 23 patients (27.71%) and had been statistically significantly more frequent among patients with partially and uncontrolled asthma (χ=8.504, p<0.05). No statistically significant difference was found between infection episodes and perinatal complications. The incidence of cesarean section was significantly higher among patients with asthma (χ=16.37, p<0.01), particularly in patients with severe asthma (χ=7.07, p<0.05) and uncontrolled asthma (χ=6.7, p<0.05). Apgar score was statistically significantly lower in patients with severe asthma (χ=20.37, p<0.05).

Conclusions: Respiratory tract infections and adequate asthma treatment are the most important modifiable factors in preventing perinatal complications associated with asthma.

References

Garne E, Vinkel Hansen A, Morris J, Zaupper L, Addor M, Barisic I . Use of asthma medication during pregnancy and risk of specific congenital anomalies: A European case-malformed control study. J Allergy Clin Immunol. 2015; 136(6):1496-1502.e7. DOI: 10.1016/j.jaci.2015.05.043. View

Murphy V, Clifton V, Gibson P . Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax. 2006; 61(2):169-76. PMC: 2104591. DOI: 10.1136/thx.2005.049718. View

Yland J, Bateman B, Huybrechts K, Brill G, Schatz M, Wurst K . Perinatal Outcomes Associated with Maternal Asthma and Its Severity and Control During Pregnancy. J Allergy Clin Immunol Pract. 2020; 8(6):1928-1937.e3. DOI: 10.1016/j.jaip.2020.01.016. View

Liu X, Agerbo E, Schlunssen V, Wright R, Li J, Munk-Olsen T . Maternal asthma severity and control during pregnancy and risk of offspring asthma. J Allergy Clin Immunol. 2017; 141(3):886-892.e3. DOI: 10.1016/j.jaci.2017.05.016. View

Sheiner E, Mazor M, Levy A, Wiznitzer A, Bashiri A . Pregnancy outcome of asthmatic patients: a population-based study. J Matern Fetal Neonatal Med. 2005; 18(4):237-40. DOI: 10.1080/14767050500260616. View

Rastogi D, Wang C, Lendor C, Rothman P, Miller R . T-helper type 2 polarization among asthmatics during and following pregnancy. Clin Exp Allergy. 2006; 36(7):892-8. PMC: 2213560. DOI: 10.1111/j.1365-2222.2006.02519.x. View

Nittner-Marszalska M, Liebhart J, Pawlowicz R, Kazimierczak A, Marszalska H, Kraus-Filarska M . Fractioned exhaled nitric oxide (FE(NO)) is not a sufficiently reliable test for monitoring asthma in pregnancy. Nitric Oxide. 2013; 33:56-63. DOI: 10.1016/j.niox.2013.06.001. View

Gordon M, Niswander K, BERENDES H, Kantor A . Fetal morbidity following potentially anoxigenic obstetric conditions. VII. Bronchial asthma. Am J Obstet Gynecol. 1970; 106(3):421-9. DOI: 10.1016/0002-9378(70)90371-6. View

Kemppainen M, Lahesmaa-Korpinen A, Kauppi P, Virtanen M, Virtanen S, Karikoski R . Maternal asthma is associated with increased risk of perinatal mortality. PLoS One. 2018; 13(5):e0197593. PMC: 5959067. DOI: 10.1371/journal.pone.0197593. View

10.

Murphy V, Wang G, Namazy J, Powell H, Gibson P, Chambers C . The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta-analysis. BJOG. 2013; 120(7):812-22. DOI: 10.1111/1471-0528.12224. View

11.

Zetstra-van der Woude P, Sebastiaan Vroegop J, Bos H, de Jong-van den Berg L . A population analysis of prescriptions for asthma medications during pregnancy. J Allergy Clin Immunol. 2012; 131(3):711-7. DOI: 10.1016/j.jaci.2012.08.027. View

12.

Palmsten K, Schatz M, Chan P, Johnson D, Chambers C . Validation of the Pregnancy Asthma Control Test. J Allergy Clin Immunol Pract. 2016; 4(2):310-5.e1. PMC: 4789157. DOI: 10.1016/j.jaip.2015.11.019. View

13.

Beau A, Didier A, Hurault-Delarue C, Montastruc J, Lacroix I, Damase-Michel C . Prescription of asthma medications before and during pregnancy in France: An observational drug study using the EFEMERIS database. J Asthma. 2016; 54(3):258-264. DOI: 10.1080/02770903.2016.1214731. View

14.

Wang G, Murphy V, Namazy J, Powell H, Schatz M, Chambers C . The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2013; 27(9):934-42. DOI: 10.3109/14767058.2013.847080. View

15.

Dor-Wojnarowska A, Nittner-Marszalska M, Liebhart J, Marszalska H, Pawlowicz R, Gillert M . [The long-term variability of FeNO in pregnant asthmatic women with controlled asthma]. Pneumonol Alergol Pol. 2013; 81(2):114-20. View

16.

Xu Z, Doust J, Wilson L, Dobson A, Dharmage S, Mishra G . Asthma severity and impact on perinatal outcomes: an updated systematic review and meta-analysis. BJOG. 2021; 129(3):367-377. DOI: 10.1111/1471-0528.16968. View

17.

Murphy V, Gibson P . Asthma in pregnancy. Clin Chest Med. 2011; 32(1):93-110. DOI: 10.1016/j.ccm.2010.10.001. View

18.

Murphy V, Powell H, Wark P, Gibson P . A prospective study of respiratory viral infection in pregnant women with and without asthma. Chest. 2013; 144(2):420-427. PMC: 7107276. DOI: 10.1378/chest.12-1956. View

19.

. The Apgar Score. Pediatrics. 2015; 136(4):819-22. DOI: 10.1542/peds.2015-2651. View

20.

Ali Z, Nilas L, Ulrik C . Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma: A case control study. Respir Med. 2016; 120:124-130. DOI: 10.1016/j.rmed.2016.10.004. View