- Title
- Severe asthma exacerbations during pregnancy
- Creator
- Murphy, Vanessa E.; Gibson, Peter; Talbot, Philippa L.; Clifton, Vicki L.
- Relation
- Obstetrics and Gynecology Vol. 106, no. 5, p. 1046-1054
- Publisher
- American College of Obstetricians / Gynecologists and Lippincott, Williams & Wilkins
- Resource Type
- journal article
- Date
- 2005
- 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% Cl 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.
- Subject
- maternal asthma; fetal-growth; mechanisms; morbidity
- Identifier
- uon:450
- Identifier
- http://hdl.handle.net/1959.13/25269
- Identifier
- ISSN:0029-7844
- Language
- eng
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