- Title
- Influence of maternal body mass index and macrophage activation on asthma exacerbations in pregnancy
- Creator
- Murphy, Vanessa E.; Jensen, Megan E.; Powell, Heather; Gibson, Peter G.
- Relation
- Funding BodyNHMRCGrant Number455593 http://purl.org/au-research/grants/nhmrc/455593
- Relation
- Journal of Allergy and Clinical Immunology: In Practice Vol. 5, Issue 4, p. 981-987.e1
- Publisher Link
- http://dx.doi.org/10.1016/j.jaip.2017.03.040
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2017
- Description
- Background: Obesity is a risk factor for exacerbations of asthma, but the mechanisms of this effect in pregnancy are unknown. Objective: This study determined the influence of maternal body mass index, gestational weight gain, eosinophilic inflammation, and systemic macrophage activation on the risk of exacerbations during pregnancy. Methods: Women with asthma (n = 164) participated in the study. Body mass index recorded at baseline (17 weeks gestation) was categorized as healthy weight (18.5-24.9 kg/m²), overweight (25-29.9 kg/m²), or obese ( > 30 kg/m²). Exacerbations requiring medical intervention were recorded prospectively. Asthma control, medication use, and fractional exhaled nitric oxide were assessed monthly; additional visits occurred during exacerbations. Peripheral blood was collected at baseline for the measurement of eosinophils, soluble CD-163, C-reactive protein, and IL-6. Results: Exacerbations occurred in a higher proportion of overweight (51.1%) and obese (48.4%) women compared with healthy weight women (25%; P =.026). Excess weight gain during pregnancy was not associated with exacerbation risk. Macrophage activation (elevated serum soluble CD-163) was associated with exacerbations requiring oral corticosteroids (P =.043), whereas high peripheral blood eosinophils or fractional exhaled nitric oxide were not associated with exacerbation or oral corticosteroid use. Conclusions: Being overweight or obese confers a greater risk of asthma exacerbation during pregnancy, and may be due to systemic macrophage activation.
- Subject
- asthma; pregnancy; exacerbating; macrophage; CD163; inflammation; eosinophil; exhaled nitric oxide
- Identifier
- http://hdl.handle.net/1959.13/1387674
- Identifier
- uon:32651
- Identifier
- ISSN:2213-2198
- Rights
- © 2017. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.
- Language
- eng
- Full Text
- Reviewed
- Hits: 2864
- Visitors: 3387
- Downloads: 216
Thumbnail | File | Description | Size | Format | |||
---|---|---|---|---|---|---|---|
View Details Download | ATTACHMENT02 | Author final version | 318 KB | Adobe Acrobat PDF | View Details Download |