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

Abstract

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.

Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression

“…The 102 research reports (31-67, 69-132) yielded 198 GDM prevalence studies. Iran (32.3%) (41,(69)(70)(71)(72)(73)(74)(75)(76)(77) and Saudi Arabia (24.2%) contributed to most of the prevalence studies, followed by Qatar (9.7%). In these prevalence studies, a total of 279,202 pregnant women were tested for GDM between 2000 and 2019, and the crude GDM prevalence was estimated to be about 11.0%.…”

“…Overall, the research reports were judged to be of potentially low RoB, with an average of seven of the nine measured assessment items. Four (4.0%) of the reports(70,85,105,120) were of low RoB in all of the assessed RoB items (Supplementary File 8). total of 102 eligible research reports comprising 198 GDM prevalence studies were reported in 16 countries in the MENA region between 2000 and 2019.…”

Prevalence of asthma and other allergic diseases in pregnant women

“…non-hormonal factors may contribute to asthma's improvement during pregnancy and that the control of asthmatic airway smooth muscle may not be exactly the same as that of the myometrium and gut (5,21). However, unlike Luik's study, we took into account physiological measurements such as spirometry, as well as symptoms, exacerbations of asthma, such as smoking, colds, and that it is the strength of the current study, while others only survived asthma symptoms (25,26). The result was a significant association between asthma and age, place of residence, family history, and ethnicity, number of pregnancy and parity.…”

Quality of life and asthma control in pregnant women with asthma

“…The study had as main objective the assessment of the relationship between asthma and complications of pregnancy and birth [ 16 ], as second objective quality of life in pregnant women with asthma should be assessed in relation to asthma severity and control. Sample size was determined based on a preliminary study that estimated a prevalence of asthma in pregnancy of 5%.…”