Asthma in pregnancy: An update

Couillard, Simon; Connolly, Clare; Borg, Catherine; Pavord, Ian

doi:10.1177/1753495x20965072

Cited by 18 publications

(20 citation statements)

References 120 publications

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“…If a mother has been taking chronic oral prednisone for more than 2 weeks, use of higher dosage of intravenous corticosteroids is recommended during labor and delivery to prevent an adrenal crisis 36…”

Section: Peripartum Managementmentioning

confidence: 99%

Asthma in Pregnancy

Rao,

Modugula,

Gaviglia

et al. 2023

Critical Care Nursing Quarterly

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Asthma is a common chronic respiratory condition that affects approximately 10% of adult women in the United States. Pregnancy can present unique challenges for women with asthma, as changes in the body can alter the severity and management of asthma-related respiratory symptoms. In this article, we review the current understanding of asthma during pregnancy, including the direct effects of the disease state on the pregnant woman and fetus, risk factors for poor control of disease, as well as current treatment recommendations.

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Section: Peripartum Managementmentioning

confidence: 99%

Asthma in Pregnancy

Rao,

Modugula,

Gaviglia

et al. 2023

Critical Care Nursing Quarterly

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“…formoterol and budesonide, can be recommended as step one asthma therapy [49]. If required to achieve asthma control, it can be used as both maintenance and reliever therapy (MART), which has been shown to be effective in asthma management resulting in lower overall use of ICS and fewer exacerbations [49,50]. SABA can be used as reliever therapy, but always together with maintenance ICS in fixed combination with LABA if required.…”

Section: Asthma Management During Pregnancymentioning

confidence: 99%

Challenges in the successful management of asthma during conception, pregnancy and delivery

Gade

Tidemandsen

Hansen

et al. 2022

Breathe

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Asthma and infertility are the most common disorders among women of reproductive age. Time to pregnancy is prolonged in women with asthma, and importantly, age seems to be a more important risk factor regarding fertility in women with asthma compared to women without asthma. Some data have shown a higher frequency of miscarriages in women with asthma, although the data are conflicting on this issue as studies have observed no association between asthma and pregnancy loss. Furthermore, studies have shown no negative effect of asthma on the total number of offspring. Pregnancy may, thus, have a significant impact on women with asthma, as well as on their offspring.The age of the women has an important impact on ability to conceive, but also for the pregnancy itself, with higher risk of uncontrolled asthma as well as asthma exacerbations with increasing age. Well-controlled asthma decreases the risk of maternal and fetal complications, while poorly controlled and undertreated asthma is associated with a range of risks for both mother and fetus. Asthma treatment should follow the general guidelines for asthma therapy, irrespective of pregnancy status, including treatment with inhaled corticosteroids, β2-agonists and muscarinic antagonists. Targeted treatment with biologics for severe asthma seems to be without important adverse effects. The use of systemic corticosteroids may be associated with adverse events during the first trimester; however, an exacerbation with the associated risk of hypoxaemia is worse for the fetus. Best possible asthma control may be achieved using repeated measurements of fractional exhaled nitric oxide (FENO), as the use of FENO compared with symptoms registration only has been shown to reduce exacerbation rate.In conclusion, women with asthma should be encouraged to conceive at an early age, might experience miscarriages, but the number of offspring are the same as in women without asthma. Well treated asthma is important for the well-being of both the mother and the unborn fetus.

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“…Asthma is the most common chronic disease complicating pregnancy [ 1 ]. It commonly manifests as frequent episodes of wheezing, dyspnoea and nocturnal cough.…”

Section: Introductionmentioning

confidence: 99%

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Rajapakse

Wickramasinghe²,

Warnasekara³

et al. 2022

PLoS ONE

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Objectives To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography. Methods We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters. Results We recruited 3374 pregnant women aged 15–48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89–0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women. Conclusion This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.

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Asthma in pregnancy: An update

Cited by 18 publications

References 120 publications

Asthma in Pregnancy

Asthma in Pregnancy

Challenges in the successful management of asthma during conception, pregnancy and delivery

Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

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