Asthma management during pregnancy: how long before we can all breathe a little easier?

Grzeskowiak, Luke E.; Clifton, Vicki L.

doi:10.3109/02770903.2015.1040494

Cited by 12 publications

(11 citation statements)

References 16 publications

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“…In general, asthma prevalence depends on geographical area, local environmental and climatic conditions, lifestyle factors, vegetation, and air pollution. Demissie reported that asthma affected between 0.4 and 1.3% of pregnant women in New Jersey [ 41 ], whereas the prevalence of AP in Australia was calculated to be 12% [ 33 ]. It is also possible that variations in asthma prevalence are in part due to epigenetic factors and environmental exposures during the early childhood [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Prospective cohort study of pregnancy complications and birth outcomes in women with asthma

Fazel

Kundi

Jensen‐Jarolim

et al. 2018

Arch Gynecol Obstet

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BackgroundAsthma is the most common potentially serious medical complication in pregnancy. The purpose of this study was to determine the association between maternal asthma and a spectrum of adverse neonatal and maternal outcomes.MethodsEvents during pregnancy and birth outcome were evaluated in 34 asthmatic as well as 1569 non-asthmatic pregnant women who were enrolled in a prospective cohort study undertaken at the antenatal clinics of Mobini Hospital in Iran. The women were interviewed and classified according to clinical severity and asthma control as per GINA guidelines. Information on asthma symptoms was collected by a questionnaire as well as by spirometry and physical examination. All subjects were followed until delivery, and postpartum charts were reviewed to assess neonatal and maternal outcomes. Eosinophil cells counts were obtained and total IgE was measured by ELISA. Results were assessed by multivariate logistic regression adjusting for maternal age and parity, and for birth outcomes, for gestational diabetes, and hypertension/pre-eclampsia.ResultsThe well-known relationship between family history of asthma and asthma in pregnancy was again supported (p < 0.001). Women with asthma had more bleeding events 3 weeks or more before delivery (OR 3.30, 95% CI 1.41–7.26), more often placenta problems (OR 6.86, 95% CI 1.42–33.02), and gestational diabetes mellitus (OR 3.82, 95% CI 1.06–13.75). No significant differences between asthmatic and non-asthmatic mothers regarding duration of gestation, birthweight, low Apgar scores, or neonatal respiratory difficulties were found. Total IgE antibody levels and eosinophil counts did not differ by asthma control and severity.ConclusionsAsthma in pregnancy poses some risk for pregnancy complications and adverse perinatal outcomes. Managing asthma effectively throughout pregnancy could benefit women and their babies and help to reduce the health burden associated with asthma during pregnancy.

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Section: Discussionmentioning

confidence: 99%

Prospective cohort study of pregnancy complications and birth outcomes in women with asthma

Fazel

Kundi

Jensen‐Jarolim

et al. 2018

Arch Gynecol Obstet

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“…This is important as women and healthcare professionals express concerns regarding the safety of preventer medications such as ICS during pregnancy. These concerns lead to poor adherence and discontinuation of asthma medications during pregnancy, with negative impacts on asthma control and pregnancy outcomes [7]. Preconception management in asthma is likely important in optimising pregnancy outcomes, especially given that 50% of asthma exacerbations occur in the first half of pregnancy [8].…”

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confidence: 99%

Asthma treatment impacts time to pregnancy: evidence from the international SCOPE study

et al. 2018

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Asthma is a common chronic disease affecting the lives of reproductive age women and is associated with 8-13% of pregnancies [1]. While maternal asthma has been consistently associated with significant perinatal morbidities and mortality [2, 3], impacts on fertility are conflicting. In light of limited and conflicting evidence, the aim of this study was to examine the impact of asthma and asthma medication use on fecundability and time to pregnancy. Participants were healthy, nulliparous women recruited to the Screening for Pregnancy Endpoints (SCOPE) study between November 2004 and February 2011 in Auckland (New Zealand), Adelaide (Australia), Cork (Ireland), and Manchester and London (United Kingdom). The SCOPE study is a multicenter prospective cohort study with the primary aim of developing screening tests for prediction of pre-eclampsia, spontaneous preterm birth and small-for-gestational-age neonates. Ethical approval was obtained from local ethics committees (New Zealand AKX/02/00/364, Australia REC 1712/5/2008, London, Leeds and Manchester 06/MRE01/98 and Cork ECM5 (10) 05/02/08). All women provided written informed consent. Detailed methods have been described previously [4]. Asthma was self-reported and identified according to the question "Have you been diagnosed with asthma by a doctor?". Asthmatic women were further divided by asthma symptoms and asthma medication use and then classified as having former asthma (doctor diagnosed asthma, no symptoms in the previous 12 months and no use of asthma medications) or current asthma (doctor diagnosed asthma, symptoms in the previous 12 months or use of asthma reliever or preventer medications). Women with current asthma were further divided according to use of intermittent reliever medications only (i.e. short-acting β-agonists (SABA)) or additional use of reliever medications (i.e. inhaled corticosteroids (ICS) with or without long-acting β-agonists (LABA)). This resulted in three asthmatic subgroups: former asthma, SABA and ICS±LABA. Information was collected on demographics, smoking, family, medical and gynaecological history, and anthropometry (height and weight). Maternal ethnicity was self-reported and categorised as Caucasian or other. The socioeconomic index is a measure of socioeconomic position according to income and education, corrected for age [5]. This index was calculated for all women in the SCOPE study (range 10-90), with a higher score indicating higher socioeconomic status [6]. Self-reported polycystic ovary syndrome was categorised as yes (confirmed by a scan and/or a blood test) or no/unsure. Cigarette use in the 3 months pre-pregnancy was coded as any versus not smoking. Age at menarche was reported as a continuous variable. Information collected from the biological father included age and BMI. Self-reported time to pregnancy (TTP) was defined as the duration of sex (in months) without contraception before the current pregnancy and was collected in the first trimester. Subfertility was defined as TTP >12 months. Fecundability odds ratio...

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“…The most important issue, however, is that mothers and often even general practitioners perceive the potential harmful effects from drugs as more severe and more frequent than those caused by the disease itself [134][135][136]. An indicative figure in this regard is the high percentage of pregnant women treated with bronchial asthma [137,138] and therefore at risk of severe complications of the fetus [139].…”

Section: Urticaria In Pregnancymentioning

confidence: 99%

Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology

et al. 2020

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Background: Urticaria is a disorder affecting skin and mucosal tissues characterized by the occurrence of wheals, angioedema or both, the latter defining the urticaria-angioedema syndrome. It is estimated that 12-22% of the general population has suffered at least one subtype of urticaria during life, but only a small percentage (estimated at 7.6-16%) has acute urticaria, because it is usually self-limited and resolves spontaneously without requiring medical attention. This makes likely that its incidence is underestimated. The epidemiological data currently available on chronic urticaria in many cases are deeply discordant and not univocal, but a recent Italian study, based on the consultation of a national registry, reports a prevalence of chronic spontaneous urticaria of 0.02% to 0.4% and an incidence of 0.1-1.5 cases/1000 inhabitants/year. Methods: We reviewed the recent international guidelines about urticaria and we described a methodologic approach based on classification, pathophysiology, impact on quality of life, diagnosis and prognosis, differential diagnosis and management of all the types of urticaria. Conclusions: The aim of the present document from the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) is to provide updated information to all physicians involved in diagnosis and management of urticaria and angioedema.

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Asthma management during pregnancy: how long before we can all breathe a little easier?

Cited by 12 publications

References 16 publications

Prospective cohort study of pregnancy complications and birth outcomes in women with asthma

Prospective cohort study of pregnancy complications and birth outcomes in women with asthma

Asthma treatment impacts time to pregnancy: evidence from the international SCOPE study

Urticaria: recommendations from the Italian Society of Allergology, Asthma and Clinical Immunology and the Italian Society of Allergological, Occupational and Environmental Dermatology

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