A Meta-analysis of Adverse Perinatal Outcomes in Women With Asthma

Abstract

Objective: This meta-analysis sought to establish if maternal asthma is associated with an increased risk of adverse perinatal outcomes and to determine the size of these effects. Search Strategy: Electronic databases were searched for the following terms: (asthma or wheeze) and (pregnan* or perinat* or obstet*). Selection Criteria: Cohort studies published between 1975 and March 2009 were considered for inclusion. Studies were included if they reported at least one perinatal outcome in pregnant women with and without asthma. Data Collection and Analysis: 103 articles were identified, and 40 publications involving 1,637,180 subjects were included. Meta-analysis was conducted with subgroup analyses by study design and active asthma management. Main Results: Maternal asthma was associated with an increased risk of low birth weight (relative risk[RR]1.46, 95% confidence interval[

Effect of pregnancy in asthma on health care use and perinatal outcomes

“…19 Interestingly, a more recent meta-analysis conducted by the same study group indicated that maternal asthma was consistently associated with an increased risk of low birth weight and preeclampsia, whereas the risks of preterm delivery and preterm labor were reduced to nonsignificant levels by active asthma management with the potential to reduce exacerbations. 10 In addition, more increased risk of pregnancy-induced hypertension among uncontrolled asthma was reported by Blais et al 37 The rate of cesarean section in our study subjects with asthma was 19.4% (27.1% in group A and 18.9% in group B), which was not higher than the average cesarean delivery rate of around 36% of all births in Korea between 2011 and 2013. However, patients who had acute exacerbations during pregnancy were more likely to undergo cesarean section than those who had not, and the significance was maintained, even after excluding certain indications for elective cesarean section or failed induction.…”

“…1,3,5 Maternal asthma during pregnancy increases the risk of poor perinatal outcomes, including low birth weight, preterm delivery, preeclampsia, and perinatal fetal death. [6][7][8][9][10][11][12][13] Moreover, asthma exacerbations during pregnancy have been linked to these outcomes. [14][15][16][17][18] However, these studies have had conflicting results in terms of corticosteroid use, general treatments, and asthma severity.…”

Validation of the Asthma Control Test in pregnant asthmatic women

“…Improvement is observed in one-third of cases, deterioration in another third and no change in the remainder [4]. Pregnant asthmatic women are at an increased risk of experiencing preeclampsia, premature delivery, intrauterine growth restriction, and of being submitted for cesarean section [1,5]. Furthermore, asthmatic exacerbations during pregnancy are associated with an increased risk of congenital malformations [6].…”

Collaborative targeted learning using regression shrinkage

“…In pregnancy, asthma is a highly prevalent chronic condition that can affect the health of the mother and fetus. () The current standard of asthma treatment during pregnancy is to continue medication because poorly controlled symptoms pose an acute risk to the fetus and mother . The primary medications suggested for moderate persistent asthma control during pregnancy are either a low dose (>0‐250 μg) of inhaled corticosteroids (ICS) combined with long‐acting β 2 agonists (LABA) or a medium dose (>250‐500 μg) of ICS without LABA.…”