Asthma morbidity during pregnancy can be predicted by severity classification

Area of Science:

• Obstetrics and Gynecology
• Pulmonology
• Clinical Medicine

Background:

• The 1993 National Asthma Education Program Working Group on Asthma and Pregnancy established asthma severity classifications (mild, moderate, severe) based on symptoms and spirometry.
• Previous studies have not evaluated the link between this classification and asthma-related complications during pregnancy.

Purpose of the Study:

• To assess the relationship between pre-pregnancy asthma severity classification and the occurrence of asthma exacerbations during pregnancy.

Main Methods:

• A cohort of 1739 pregnant women with asthma, less than 26 weeks' gestation, were classified using the 1993 criteria, modified to include medication needs.
• Subsequent asthma morbidity, including hospitalizations, unscheduled visits, corticosteroid use, and symptom reporting, was tracked throughout gestation.

Main Results:

• Initial asthma severity classification significantly correlated with pregnancy-related asthma morbidity.
• Rates of exacerbations were 12.6% for mild, 25.7% for moderate, and 51.9% for severe asthma (P <.001).
• Reclassification during pregnancy impacted morbidity, with changes observed in patients initially mild or moderate-severe.

Conclusions:

• The adapted National Asthma Education Program classification effectively predicts asthma morbidity in pregnant individuals.
• Incorporating medication requirements into the classification enhances its predictive value for gestational asthma complications.