Severity of asthma and perinatal outcome

Perlow, JH; Montgomery, D. A. D.; Ma, Min; Towers, CV; Porto, Murilo de Jesus

doi:10.1016/0020-7292(93)90588-n

Cited by 30 publications

(50 citation statements)

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“…On the other hand, our results differ from those of Perlow et al, Bracken et aland Dombrowski et alwho found no significant increased risk of SGA associated with asthma [16,17,40]. Lack of adjustment for several potential confounders and lack of power due to small sample sizes probably explain the differences in results.…”

Section: Discussioncontrasting

confidence: 85%

“…Considering the high prevalence of asthma among pregnant women and the fact that uncontrolled asthma has been associated with adverse perinatal outcomes [8,16,40], it is essential to develop preventive, therapeutic and health care strategies to insure an optimal treatment of asthma during pregnancy to minimize the adverse perinatal outcomes of asthma.…”

Section: Discussionmentioning

confidence: 99%

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Impact of maternal asthma on perinatal outcomes: a two-stage sampling cohort study

et al. 2012

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There are conflicting results concerning the impact of maternal asthma during pregnancy on perinatal outcomes. The present study investigated the associations between maternal asthma during pregnancy and the risk of a small-for-gestational-age (SGA) infant, a low-birth-weight (LBW) infant, and preterm birth. A population-based cohort of 40,788 pregnancies from asthmatic and non-asthmatic women was reconstructed through the linking of three Quebec (Canada) administrative databases between 1990 and 2002. A two-stage sampling cohort design was used to collect additional information by way of a mailed questionnaire. The generalized estimation equation models were used to obtain adjusted odds ratios of SGA, LBW and preterm birth comparing asthmatic and non-asthmatic women. The cohort included 13,007 pregnancies from asthmatic and 27,781 pregnancies from non-asthmatic women. Final estimates showed that the odds of SGA (odds ratio: 1.27, 95% confidence interval: 1.14, 1.41), LBW (1.41: 1.22, 1.63) and preterm delivery (1.64: 1.46, 1.83) were significantly higher among asthmatic than non-asthmatic women. Mothers with asthma during pregnancy are more likely to have SGA, LBW, or preterm birth infants than non-asthmatic women. These results can be more easily generalized to women with lower socio-economic status since the cohort under represents women with high socio-economic status.

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Section: Discussioncontrasting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Impact of maternal asthma on perinatal outcomes: a two-stage sampling cohort study

et al. 2012

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“…6 Slightly decreased birth weight in infants born to women who used LTRAs in our study is most likely attributable to more severe and/or poorly controlled maternal asthma in that group. Maternal asthma has been associated with an increased risk of low birth weight, [26][27][28][29] reduced mean birth weight, 28,30 and intrauterine growth restriction 6,26,31,32 (reviewed by Bakhireva et al 22 ). Moreover, relationships have been reported between reduced intrauterine growth and more severe or poorly controlled asthma, as defined by lower pulmonary function, 5 increased symptoms, 6 or exacerbations.…”

Section: Discussionmentioning

confidence: 98%

Safety of leukotriene receptor antagonists in pregnancy

Bakhireva¹,

Jones²,

Schatz³

et al. 2007

Journal of Allergy and Clinical Immunology

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“…Studies of women with wellcontrolled asthma, which involves the use of inhaled glucocorticoids to inhibit inflammatory mechanisms at a systemic level, seldom demonstrate adverse effects on fetal outcome (Schatz et al 1995;Bracken et al 2003). However, the regular use of oral glucocorticoids for the treatment of asthma during pregnancy is known to be associated with an increased incidence of low birthweight babies and preterm births (Bracken et al 2003;McDonald and Burdon 1996;Fitzsimons et al 1986;Perlow et al 1992). Inhaled glucocorticoid treatment has a number of known systemic effects, including adrenal suppression and reduced bone density in non-pregnant adults (Kos-Kudla and Pluskiewicz 1997;Lipworth 1996).…”

Section: Effect Of Asthma During Pregnancy On Maternal Health and Fetmentioning

confidence: 96%

Sexually dimorphic effects of maternal asthma during pregnancy on placental glucocorticoid metabolism and fetal growth

Clifton

2005

Cell Tissue Res

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Human pregnancy is associated with sexually dimorphic differences in mortality and morbidity of the fetus with the male fetus experiencing the poorest outcome following complications such as pre-eclampsia, pre-term delivery and infection. The physiological mechanisms that confer these differences have not been well characterised in the human. Work conducted on the effect of maternal asthma during pregnancy, combining data collected from the mother, placenta and fetus has found some significant sex-related mechanistic differences associated with fetal growth in both normal pregnancies and pregnancies complicated by asthma. Specifically, sexually dimorphic differences have been found in placental glucocorticoid metabolism in male and female fetuses of normal pregnancies. In response to the presence of maternal asthma, only the female fetus alters placental glucocorticoid metabolism resulting in decreased growth. The male fetus does not alter placental function or growth in response to maternal asthma. As a result of the alterations in glucocorticoid metabolism in the female, downstream changes occur in pathways regulated by glucocorticoids. These data suggest that the female fetus adjusts placental function and reduces growth to compensate for maternal disease. However, the male fetus continues to grow in response to maternal asthma with no changes in placental function. This response by the male fetus may partially contribute to the increased risk of morbidity and mortality in this sex.

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Severity of asthma and perinatal outcome

Cited by 30 publications

References 0 publications

Impact of maternal asthma on perinatal outcomes: a two-stage sampling cohort study

Impact of maternal asthma on perinatal outcomes: a two-stage sampling cohort study

Safety of leukotriene receptor antagonists in pregnancy

Sexually dimorphic effects of maternal asthma during pregnancy on placental glucocorticoid metabolism and fetal growth

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