The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta‐analysis

Murphy, VE; Wang, G; Namazy, J.A.; Powell, Heather; Gibson, Peter G.; Chambers, Christina D.; Schätz, Michael

doi:10.1111/1471-0528.12224

Cited by 148 publications

(121 citation statements)

References 61 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Using a 10 cm visual analog scale, where 0 cm represented no perceived risk and 10 cm represented major risk (e.g., birth defects), Powell et al found that women assigned minimal risk to the SABA salbutamol (mean 0.5 cm), with greater perceived risks being associated with ICS use (mean 1.2 cm) and oral corticosteroids (4.5 cm) [40]. A recent systematic review and meta-analysis of over 56,000 pregnancies with asthma and over 1 million pregnancies without asthma from 14 studies found a significant but very small increased risk of congenital malformations among women with asthma compared with women without asthma (RR: 1.11; 95% CI: 1.02-1.21) [41]. In addition, data combined from two studies found an increased risk of cleft lip with or without cleft palate (RR: 1.30; 95% CI: 1.01-1.68).…”

Section: Management Of Asthma During Pregnancy According To the 2008 mentioning

confidence: 99%

Maternal Complications and the Management of Asthma in Pregnancy

Vanders

Murphy

2015

Womens Health (Lond Engl)

View full text Add to dashboard Cite

Pregnancy is a unique state requiring alterations in maternal physiology to accommodate the growing fetus. Whilst the maternal immune system is normally well adept at performing this task, the presence of immune disorders, such as asthma, often lead to pregnancy-related complications affecting both mother and baby. Australia has a high prevalence of asthma; with approximately 12% of pregnant women reported to have current asthma. Poor control of asthma is of far greater risk than the use of asthma medications. Being able to identify complications associated with asthma during pregnancy is of great importance in providing appropriate asthma management and medical care to these pregnant women, which may have lifelong consequences for their offspring.

show abstract

Section: Management Of Asthma During Pregnancy According To the 2008 mentioning

confidence: 99%

Maternal Complications and the Management of Asthma in Pregnancy

Vanders

Murphy

2015

Womens Health (Lond Engl)

View full text Add to dashboard Cite

show abstract

“…Over the past few years, a large systematic review and a series of meta-analyses have been published that summarise the literature on adverse perinatal outcomes among females with asthma [1][2][3][4]. The first review to be published, in 2011, demonstrated an increased risk of pre-eclampsia, preterm birth, low birth weight and small for gestational age among females with asthma, compared to females without asthma [1].…”

Section: Adverse Perinatal Outcomes Associated With Asthma During Prementioning

confidence: 99%

“…The systematic review and meta-analyses published in 2013 demonstrated a small but significantly increased risk of any congenital malformations among females with asthma (RR 1.11, 95% CI 1.02-1.21), but not of major malformations [2]. Specifically, cleft lip with or without cleft palate was significantly increased among females with asthma compared to females without asthma (RR 1.30, 95% CI 1.01-1.68).…”

Section: Adverse Perinatal Outcomes Associated With Asthma During Prementioning

confidence: 99%

Asthma in pregnancy: a hit for two

Murphy

Schatz

2014

European Respiratory Review

View full text Add to dashboard Cite

Asthma commonly occurs in pregnant females, and recent data have outlined the risks of adverse perinatal outcomes among this population. There is an increased risk of low birth weight and small for gestational age, particularly among females with moderate-to-severe asthma and exacerbations during pregnancy. There is also an increased risk of preterm birth, especially with oral steroid use, a small but statistically significant increased risk of congenital malformations, particularly of cleft lip with or without cleft palate, and an increased risk of neonatal hospitalisation and death. Active management may reduce these risks, possibly through reductions in exacerbations.Additional reassuring data have been presented for asthma medication use, which support the benefits outweighing the risks of indicated asthma medication use in pregnancy. Viral infections are an important trigger of asthma exacerbations in pregnancy, and recent data provides possible immunological changes that may explain this. Poor medication adherence despite worsening asthma symptoms in pregnancy is a problem which continues to be demonstrated in the literature. Improving asthma control in pregnancy has the potential to improve not only the mother's health but also that of her child. @ERSpublications Improving asthma control in pregnancy has the potential to improve the mother's health and that of her child

show abstract

“…A summary of the early literature was published in 2007 [1]. Since then further studies have appeared and recent reviews are available [2,3]. A meta-analysis in the latter article found a weighted total odds ratio for a major malformation from four relatively large cohort studies of 1.18 (95% CI 1.00-1.36).…”

Section: Introductionmentioning

confidence: 99%

Maternal Asthma and Use of Antiasthmatic Drugs in Early Pregnancy and Congenital Malformations in the Offspring

Källén¹

2014

J Pulm Respir Med

View full text Add to dashboard Cite

Objectives: To investigate the risk of congenital malformations in infants born of women who had used antiasthmatic drugs in early pregnancy.Methods: Data were obtained from the Swedish Medical Birth Register for 1996-2011. Information on drug use was based on midwife interviews towards the end of the first trimester. Presence of congenital malformations was ascertained from three national health registers. Risk estimates were made with Mantel-Haenszel odds ratios after adjustment for delivery year, maternal age, parity, smoking, and body mass index. Consideration was taken to concomitantly used drugs.Results: Among more than 1.5 million women who gave birth, 2.9% reported the use of antiasthmatics. These women had characteristics which distinguished them from other women who gave birth and they more often than these used other drugs than antiasthmatics. These differences seemed to affect malformation risk only little. The risk for a major malformation was slightly but significantly increased (odds ratio=1.09, 95% confidence interval 1.03-1.12), specifically this was seen for cardiovascular defects, median cleft palate, and pyloric stenosis. There was no specific association with specific drugs or drug groups, the highest risk estimate was seen for women who used only one drug and notably a short-acting adrenergic or used three or more antiasthmatic drug groups. Conclusion:The absolute risk for a congenital malformation in infants born of women using antiasthmatics is low and some evidence indicates that it is due to underlying asthma. A good control of asthma seems important and scare of teratogenicity of the common antiasthmatic drugs should not prevent adequate use.

show abstract

The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta‐analysis

Cited by 148 publications

References 61 publications

Maternal Complications and the Management of Asthma in Pregnancy

Maternal Complications and the Management of Asthma in Pregnancy

Asthma in pregnancy: a hit for two

Maternal Asthma and Use of Antiasthmatic Drugs in Early Pregnancy and Congenital Malformations in the Offspring

Contact Info

Product

Resources

About