Determining the Clinical Course of Asthma in Pregnancy

Stevens, Danielle; Perkins, Neil J.; Chen, Zhe; Kumar, Rajesh; Grobman, William A.; Subramaniam, Akila; Biggio, Joseph; Grantz, Katherine L.; Sherman, Seth; Rohn, Matthew C.H.; Mendola, Pauline

doi:10.1016/j.jaip.2021.09.048

Cited by 15 publications

(10 citation statements)

References 31 publications

(55 reference statements)

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“…However, more recent research suggests that fewer patients may improve than previously reported. A recent US cohort study of 308 pregnant women with asthma found that 59.5% of participants experienced unchanged asthma symptoms, whereas 40.5% of participants reported worse asthma symptoms [8 ▪ ]. No participants in this study reported improving symptoms.…”

Section: Epidemiologycontrasting

confidence: 58%

Asthma in pregnancy: a review of recent literature

Colas,

Namazy

2024

Current Opinion in Pulmonary Medicine

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Purpose of review Asthma remains the most common respiratory disease in pregnancy. Identifying risk factors for asthma exacerbations during pregnancy is critical, as uncontrolled asthma can have detrimental effects for both mother and baby. In this review, we discuss recent literature exploring risk factors, fetal and maternal effects, and treatment options for asthma during pregnancy. Recent findings Recent literature suggests that optimizing asthma during pregnancy improves outcomes for both mother and baby, as well as later in childhood. Current research affirms that the benefit of asthma medication use outweighs any potential risks related to the medications themselves. Limited information is available regarding the use of newer therapies such as biologics during pregnancy. Summary Identifying risk factors for asthma exacerbations during pregnancy is critical to prevent adverse outcomes for both mother and baby. Recent evidence continues to affirm the safety of asthma medication use; more studies are needed regarding the use of new therapies during pregnancy.

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Section: Epidemiologycontrasting

confidence: 58%

Asthma in pregnancy: a review of recent literature

Colas,

Namazy

2024

Current Opinion in Pulmonary Medicine

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“…Asthma exacerbations during pregnancy may result in presentation to the emergency department, hospitalization for treatment of exacerbations, and, rarely, death. In individuals who have known asthma at pregnancy, recent data revealed that 60% of them had no change in their asthma during pregnancy but 40% had worsening of their symptoms; no individuals had improvement in their asthma . This finding differs from the previous observation that one-third of patients experience improvement, one-third have no change, and one-third have worsening of symptoms.…”

mentioning

confidence: 68%

Asthma in Pregnancy

Huang

Namazy

2023

JAMA

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“…Other measures of asthma status included self-reported asthma symptoms and exacerbations 10 . Daily diaries collected self-reported asthma symptoms including activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms including wheezing, coughing, chest tightness, chest pain, shortness of breath.…”

Section: Discussionmentioning

confidence: 99%

“…The Breathe -Wellbeing, Environment, Lifestyle and Lung Function study (B-WELL-Mom) is a multicenter prospective cohort study designed to examine the clinical course of asthma in pregnancy 10 . It was carried out between 2015 and 2019 in conjunction with two clinical sites at the University of Alabama at Birmingham (UAB) and Northwestern University (NWU).…”

Section: Study Population and Designmentioning

confidence: 99%

The Association of Periconception Asthma Medication Discontinuation with Adverse Obstetric Outcomes

et al. 2023

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Background: Asthma medication reduction is common in early pregnancy and may be an important contributor to worsening asthma in pregnancy. Methods: In a prospective cohort study, self-reported current and past asthma medications were collected and analyses compared measures of asthma status in women who discontinued asthma medication in the six months prior to enrollment (“step down”) versus those who did not (“no change”). Evaluation of asthma was done at three study visits (one per trimester) and by daily diaries, including measures of lung function (percent predicted forced expiratory volume in one and six seconds, (%FEV1, %FEV6), peak expiratory flow (%PEF), forced vital capacity (%FVC), FEV1 to FVC ratio (FEV1/FVC)), lung inflammation (fractional exhaled nitric oxide (FeNO), ppb), rate of asthma symptoms (activity limitation, night symptoms, rescue inhaler use, wheeze, shortness of breath, cough, chest tightness, chest pain), and rate of asthma exacerbations. Adverse pregnancy outcomes were also evaluated. Adjusted regression analyses examined whether adverse outcomes differed by periconceptional asthma medication changes. Results: Of 279 participants included in analyses, 135 (48.4%) did not change asthma medication in the periconceptional period while 144 (51.6%) reported a step down in medication. Those in the step-down group were more likely to have milder disease (88 (61.1%) in the step-down versus 74 (54.8%) in the no change group), exhibited less activity limitation (rate ratio (RR): 0.68, 95% CI 0.47–0.98), and experienced fewer asthma attacks (RR: 0.53, 95% CI 0.34–0.84) during pregnancy. Women in the step-down group had a non-significant increase in overall odds of experiencing an adverse pregnancy outcome (odds ratio 1.62, 95% CI 0.97–2.72). Conclusions: Over half of women with asthma reduce asthma medication in the periconceptional period. Although these women typically have milder disease, a step down in medication may be associated with an increased risk of adverse pregnancy outcomes.

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Determining the Clinical Course of Asthma in Pregnancy

Cited by 15 publications

References 31 publications

Asthma in pregnancy: a review of recent literature

Asthma in pregnancy: a review of recent literature

Asthma in Pregnancy

The Association of Periconception Asthma Medication Discontinuation with Adverse Obstetric Outcomes

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