Severity of asthma in pregnancy affects perinatal outcomes

Murphy, VE; Namazy, J.A.; Powell, Heather; Schatz, Michael; Chambers, Christina D.; Attia, John; Gibson, Peter G.

doi:10.1111/j.1471-0528.2011.03259.x

Cited by 1 publication

(1 citation statement)

References 6 publications

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“…Compared to pregnant women without asthma, women with asthma are at risk of a range of adverse pregnancy outcomes affecting the mother, placenta and neonate, including preterm delivery, low birth weight, pre-eclampsia [ 34 ], gestational diabetes, caesarean section, placenta praevia [ 36 ], congenital malformations, neonatal hospitalisation and neonatal death [ 35 ]. Despite the fact that the majority of women included in the primary studies would be expected to have mild asthma, the effect of asthma on perinatal outcomes was still significant, suggesting that there may be a greater adverse effect among the subgroup with more severe disease [ 37 ]. Indeed, women with moderate or severe asthma were more likely to have small for gestational age babies than women with mild asthma [ 16 ].…”

Section: The Importance Of Active Management For Better Maternal and mentioning

confidence: 99%

Managing asthma in pregnancy

Murphy

2015

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Asthma is a common comorbidity during pregnancy and its prevalence is increasing in the community. Exacerbations are a major clinical problem during pregnancy with up to 45% of women needing to seek medical help, resulting in poor outcomes for mothers and their babies, including low birth weight and preterm delivery. The goals of effective asthma management in pregnancy are to maintain the best possible asthma control and prevent exacerbations. This is achieved by aiming to prevent day- and night-time symptoms, and maintain lung function and normal activity. In addition, maintaining fetal oxygenation is an important consideration in pregnancy. Guidelines recommend providing asthma advice and review prior to conception, and managing asthma actively during pregnancy, with regular 4-weekly review, provision of a written action plan, use of preventer medications as indicated for other adults with asthma, and management of comorbid conditions such as rhinitis.Improvements have been made in recent years in emergency department management of asthma in pregnancy, and multidisciplinary approaches are being proposed to optimise both asthma outcomes and perinatal outcomes. One strategy that has demonstrated success in reducing exacerbations in pregnancy is treatment adjustment using a marker of eosinophilic lung inflammation, the exhaled nitric oxide fraction (FeNO). The use of an algorithm that adjusted inhaled corticosteroids (ICS) according to FeNO and added long-acting β-agonists when symptoms remained uncontrolled resulted in fewer exacerbations, more women on ICS but at lower mean doses, and improved infant respiratory health at 12 months of age. Further evidence is needed to determine whether this strategy can also improve perinatal outcomes and be successfully translated into clinical practice.Key pointsAsthma is the most common chronic disease to affect pregnant women.Exacerbations occur in up to 45% of pregnant women with asthma.Asthma should be managed during pregnancy as for other adults.Treatment adjustment using a marker of airway inflammation reduces the exacerbation rate in pregnancy.Educational aimsTo identify the goals of and steps associated with effective asthma management in pregnancy.To understand the maternal and perinatal risks associated with asthma during pregnancy.To describe a management strategy that has been shown to reduce exacerbations in pregnant women with asthma.

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Section: The Importance Of Active Management For Better Maternal and mentioning

confidence: 99%

Managing asthma in pregnancy

Murphy

2015

Breathe

View full text Add to dashboard Cite

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Severity of asthma in pregnancy affects perinatal outcomes

Cited by 1 publication

References 6 publications

Managing asthma in pregnancy

Managing asthma in pregnancy

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