Changes in pulmonary function during pregnancy: a longitudinal cohort study

Abstract

Objective To record any physiological changes in lung function during healthy pregnancies, and evaluate the influence of parity, pregestational overweight, and excessive weight gain.Design Longitudinal cohort study.Setting Antenatal clinic at Oslo University Hospital.Population One hundred healthy white women with singleton pregnancies.Methods The women were studied with repeated measures of lung function using spirometry at a gestational age of 14-16, 22-24, 30-32, and 36 weeks, and at 6 months postpartum.Main outcome measures Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF), also expressed as a percentage of predicted values according to age and height: i.e. FVC%, FEV1%, and PEF%.Results Both FVC and FVC% increased significantly after 14-16 weeks of gestation (P = 0.001), as was the case for both PEF and PEF% (P < 0.001). FVC, FVC%, PEF, and PEF% in early and mid-pregnancy were significantly lower compared with the postpartum value (all P < 0.05). Nulliparous women had an overall 4.4% lower value of FVC% than parous women (P = 0.039). There were no differences in FVC, FEV1, or PEF dependent upon pregestational overweight or excessive weight gain.Conclusions Forced vital capacity (FVC) increases significantly after 14-16 weeks of gestation. The FVC% is significantly higher in parous compared with primigravida women, suggesting that the changes in FVC occurring during pregnancy persist postpartum. PEF increases significantly during healthy pregnancies, and should be interpreted cautiously in pregnant women with impaired lung function.

Relationship of Circulating C5a and Complement Factor H Levels With Disease Control in Pregnant Women With Asthma

“…Hence, it would be especially important to understand the immune interactions between asthma and gestation and to have a more detailed view into inflammatory processes of asthma during pregnancy. Furthermore, because pregnancy itself can influence spirometry results, 7 and because most of the available techniques used to determine asthma airway inflammation (eg, induced sputum) are semi-invasive and therefore cannot be used in pregnancy, circulating, non-invasively obtainable biomarkers related to asthma control could help in identifying pregnant women with asthma with elevated risk. However, to date, objective circulating markers reflecting asthma control are not known.…”

Circulating periostin level in asthmatic pregnancy

“…The explanation of this discrepancy between the asthmatic groups may be the somewhat differing clinical state of the patients, as PEF and FVC values (expressed as percentage of predicted) were lower in the pregnant than in the non-pregnant patients in our study. Notably, according to earlier results, these two lung function parameters are expected to increase in healthy pregnant women compared to the non-pregnant state; hence in our pregnant asthmatic patients these lung function results have to be regarded as actually worse than they would seem to be in non-pregnant conditions [7] and thus the association between periostin and worse lung function may be more obvious in this group. Optimal lung function and well- In our study we could not confirm the previous data [20,39] as we did not detect higher peripheral periostin levels in bronchial asthma (without pregnancy) than in healthy controls.…”

“…Hence in asthmatic pregnancy it would be especially important to have clinically usable biomarkers that would indicate the loss of asthma control and would thus help to identify asthmatic pregnant women with elevated risk of pregnancy complications. Pregnancy itself can influence spirometry results [7], and this measurement cannot be performed in all cases because it requires vigorous breathing maneuver.…”

Pulmonary Complications of Sickle Cell Disease in the Pregnant Patient

“…In a normal pregnancy increases in arterial oxygen, respiratory rate, peak expiratory flow, and forced vital capacity are expected [51]. In the case of a pregnant SCD patient, the possibility of restrictive lung disease and/or propensity for ACS may warrant aggressive incentive spirometry therapy.…”