The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis

Wang, Gang; Murphy, Vanessa E.; Namazy, Jennifer A.; Powell, Heather; Schatz, Michael; Chambers, Christina D.; Attia, John; Gibson, Peter G.

doi:10.3109/14767058.2013.847080

Cited by 90 publications

(80 citation statements)

References 54 publications

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“…The risks were increased for preeclampsia, placenta previa, placental abruption, primary weak contractions, hemorrhage around delivery, and caesarean section which agrees well with the results summarized in reviews [1,2,10].…”

Section: Journal Of Respiratory Medicinesupporting

confidence: 89%

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Use of Antiasthmatic Drugs during Pregnancy after the First Trimester and Maternal and Neonatal Outcomes

Källén

Wikner

2014

Journal of Respiratory Medicine

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Background. Women with asthma using antiasthmatics during the later part of the pregnancy have an increased risk for obstetric complications and their infants of neonatal complications. Material and Methods. The study is based on a linkage between the Swedish Medical Birth Register and a register of prescribed drugs in Sweden for the years 2009-2011, identifying women who had filled prescriptions for antiasthmatics after the first trimester. Their characteristics, their obstetric history, and the neonatal conditions of their infants were compared with all other women who gave birth. Adjusted Mantel-Haenszel odds ratios were determined. Results. We found an increased risk for a number of maternal conditions but no risk increase for gestational diabetes (after adjustment for body mass index) or for premature rupture of membranes. There was an increase in preterm births for some drugs used at severe asthma and of low birth weight and small for gestational age for most drug combinations. An increased risk was seen for neonatal hypoglycemia, respiratory problems, and low Apgar score. Conclusions. There are many hazards associated with maternal asthma and use of antiasthmatic drugs. Most evidence suggests a disease effect. A careful control of the asthma during pregnancy is important.

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Section: Journal Of Respiratory Medicinesupporting

confidence: 89%

“…One review [1] summarized the early literature. More recent reviews have been published [2][3][4]. In most studies which were large enough, an association with various maternal obstetric morbidities was demonstrated.…”

Section: Introductionmentioning

confidence: 99%

Use of Antiasthmatic Drugs during Pregnancy after the First Trimester and Maternal and Neonatal Outcomes

Källén

Wikner

2014

Journal of Respiratory Medicine

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“…The full text of all articles that definitely or possibly met the inclusion criteria was accessed independently by two reviewers, and the relevant details were extracted. Study quality was assessed as described in our previous study (17). The data extraction and quality assessment are described in detail in the Supplementary materials.…”

Section: Data Extraction and Quality Assessmentmentioning

confidence: 99%

“…Summary RR for the association between PD and different outcomes (AE, hospitalization because of asthma, ED visit because of asthma, unscheduled doctor visit because of asthma, and SCS use) were calculated using Stata Version 11.0 (Stata Corp. LP, College Station, TX). Heterogeneity in every effect estimate was assessed using the I 2 statistic and the Cochran Q method, as in our previous studies (17,18). A random-effects metaanalysis model was used to calculate pooled estimates when substantial heterogeneity was observed (I 2 >50.0%…”

Section: Statistical Analysis and Quality Of The Evidence Assessmentmentioning

confidence: 99%

Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: a systematic review and meta-analysis

Zhang

Zheng³

et al. 2016

J. Thorac. Dis.

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Background:The longitudinal associations between psychological dysfunction (PD) and asthma exacerbations (AE) have not been adequately addressed. This study aimed to systematically assess the influence of PD on AE, and to determine whether different PD affects AE differentially. P<0.001], presenting as hospitalizations (RR adj =1.22, 95% CI: 1.12-1.34, P<0.001), unscheduled doctor visits (RR =4.26, 95% CI: 2.52-7.19), and emergency department (ED) visits (RR adj =1.06, 95% CI: 1.01-1.10, P=0.009) because of asthma. Depression significantly increased the risk of AE (RR adj =1.07, 95% CI: 1.04-1.11, P<0.001), presenting as hospitalizations (RR adj =1.26, 95% CI: 1.07-1.49, P=0.007) and ED visits (RR adj =1.06, 95% CI: 1.02-1.11, P=0.007) because of asthma. Anxiety was only associated with an increased risk of AE in pregnant women (RR =1.05, 95% CI: 1.01-1.08), possibly due to the small amount of data available on anxiety. The influence of PD on AE was only significant when the PD exposure time exceeded one year.Conclusions: Co-morbid PD adversely affects AE, and there are differential effects of depression and anxiety. Asthmatic subjects with PD may benefit from more attention when establishing a treatment regimen in clinical practice.

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“…Asthma is one of the most prevalent chronic medical conditions reported during pregnancy, with a prevalence between 8% and 13% worldwide [1]. Maternal asthma is associated with significant perinatal morbidity and mortality, with increased risk of low birth weight (RR 1.46; 95%CI 1.22-1.75), small-for-gestational age (RR 1.22; 1.14-1.31), preterm birth (RR 1.41; 1.22-1.61), pre-eclampsia (RR 1.54; 1.32-1.81), gestational diabetes (RR 1.39; 1.17-1.66) and Caesarean section (RR 1.31; 1.22-1.39) [1,2]. In Australia, asthma affects an estimated 12% (437 000) pregnancies each year, with prevalence of asthma greatest (up to 16%) among the socially disadvantaged [3].…”

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confidence: 99%

Asthma management during pregnancy: how long before we can all breathe a little easier?

Grzeskowiak

Clifton

2015

Journal of Asthma

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The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis

Abstract: Pregnant women with asthma are at increased risk of maternal and placental complications, and women with moderate/severe asthma may be at particular risk. Further studies are required to elucidate whether adequate control of asthma during pregnancy reduces these risks.

Cited by 90 publications

References 54 publications

Use of Antiasthmatic Drugs during Pregnancy after the First Trimester and Maternal and Neonatal Outcomes

Use of Antiasthmatic Drugs during Pregnancy after the First Trimester and Maternal and Neonatal Outcomes

Co-morbid psychological dysfunction is associated with a higher risk of asthma exacerbations: a systematic review and meta-analysis

Asthma management during pregnancy: how long before we can all breathe a little easier?

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