Asthma and/or hay fever as predictors of fertility/impaired fecundity in U.S. women: National Survey of Family Growth

Abstract

This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.

The influence of maternal respiratory allergy on obstetrics and perinatal outcomes: A nested case–control study

“…[14][15][16] However, the age of the patients with respiratory allergies was even higher, which has also been reported in other studies, 4,17 suggesting a possible influence of allergy in women's fertility. 1,10 Likewise the data reflected the increase in maternal age at the first pregnancy during the study period, 10,14 showing that in Spain in 2000 the mean age was 30.74 years and in 2018 it was 32.2 years. 14 Regarding allergic comorbidities, drug allergy was by far the most prevalent, as shown in other studies.…”

“…1 As PTD and intrauterine growth restriction have been associated with a predominance of Th1 profile, 1 some authors have suggested that a deviation from a Th2 response may be the key for these adverse pregnancy outcomes to develop. 1,10 Asthma has been well studied, 3 but other atopic comorbidities are overlooked in our daily practice, and little is known about the possible effects of these conditions on pregnancy outcomes.…”

“…7,9 In pregnant women, predominance of Th1 reactivity has been related to infections during pregnancy and a dysregulation of T helper cell immunity to obstetrical complications, such as pre-eclampsia, spontaneous abortion, and recurrent pregnancy losses. 1,6,7,10 Atopic diseases deviate the immunologic system to a type 2 immunologic profile. 3 In addition, the immunologic response during pregnancy is to also deviate to a Th2 cytokine profile for successful maternal tolerance of the foreign fetal antigens.…”

“…2,11,12 However, other studies found associations between patients with asthma and higher time to pregnancy, risk of abortions, preterm delivery (PTD), and low birth weight (LBW). 2,10,12 Other published literature related atopic diseases with a favorable factor regarding pregnancy, showing that hay fever and asthma, and patients with only hay fever, were more fertile because of a higher rate of live births per 1000 person-years, and they were not at risk of PTD nor LBW. 1 As PTD and intrauterine growth restriction have been associated with a predominance of Th1 profile, 1 some authors have suggested that a deviation from a Th2 response may be the key for these adverse pregnancy outcomes to develop.…”

Association between Low House Cleaning Frequency, Cough and Risk of Miscarriage: A Case Control Study in China

“…The proinflammatory T2-low asthma endotype has similar biomarker characteristics to the fetal-maternal interface during implantation. Prior to implantation and in the peri-implantation period the fetal–maternal interface is also characterized by immune deviation to a proinflammatory and T2-low endotype [ 14 ]. The same mechanism underlying the T2-low asthma and miscarriage explained the high incidence of miscarriage in asthmatic women.…”