Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.13/26948

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Title
Severe asthma exacerbations during pregnancy
Author/Creator
Murphy, Vanessa Evonne;  Gibson, Peter Gerard;  Talbot, Philippa Isobel;  Clifton, Vicki Lee
Description
OBJECTIVE: To estimate the frequency of severe asthma exacerbations in pregnant women and to estimate whether there is an association with adverse perinatal outcomes. METHODS: Asthma exacerbations were evaluated in 146 women who were enrolled in a prospective cohort study of asthma and pregnancy. A severe exacerbation was defined as a hospital admission, emergency department presentation, or unscheduled doctor visit for asthma or a course of oral corticosteroids. Women were classified as having mild (n = 63), moderate (n = 34), or severe (n = 49) asthma. RESULTS: Severe exacerbations occurred in 8% (95% confidence interval [CI] 1.3–14.6%) of women with mild asthma, 47% (95% CI 30.3–63.8%) of women with moderate asthma, and 65% (95% CI 52–78.6%) of women with severe asthma at a mean gestational age of 25.1 ± 0.9 (range 9–39) weeks of gestation. Among women who had severe exacerbations, there were 2 male stillbirths (P = .102) and a significantly increased rate of male low birth weight (P = .03). Maternal age, lung function, body mass index, gravidity, and parity were not different between women who did or those who did not have a severe exacerbation. Maternal pregnancy weight gain was significantly lower in women who had a severe exacerbation (P = .039). Forty-three percent of severe exacerbations occurred in winter, 34% were associated with self-reported viral infection, and 29% with nonadherence to inhaled corticosteroid medication. CONCLUSION: The exacerbation rate among pregnant women with asthma is high and associated with poor outcomes for the male fetus. Improvements in asthma management to prevent severe exacerbations may lead to a better outcome for both mother and baby.
Relation
Obstetrics and Gynecology Vol. 106, Issue 5, p. 1046-1054
Relation
http://www.greenjournal.org
Date
2005
Publisher
American College of Obstetricians and Gynecologists and Lippincott, Williams & Wilkins
Keyword(s)
asthma exacerbations;  pregnancy;  perinatal;  corticosteroids
Resource Type
journal article
Identifier
http://hdl.handle.net/1959.13/26948
Identifier
ISSN:0029-7844
Reviewed
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Subject
"Obstetrics and Gynecology"
 
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