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Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes
Gustaf Rejnö1, Cecilia Lundholm2, Tong Gong2
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Obstetrics and Gynaecology Unit, Södersjukhuset, Stockholm, Sweden.
Insights
Maternal asthma increases risks for pregnancy complications like preeclampsia and premature contractions. Increased asthma severity correlates with higher risks of adverse perinatal outcomes, including low birth weight.
Area of Science:
- Obstetrics and Gynecology
- Pulmonology
- Perinatal Medicine
Background:
- Asthma is a prevalent chronic respiratory condition affecting women of reproductive age.
- Pregnancy can influence asthma severity and control, potentially impacting maternal and fetal health.
- Understanding the relationship between maternal asthma and pregnancy outcomes is crucial for effective management.
Purpose of the Study:
- To investigate the association between maternal asthma and pregnancy complications.
- To evaluate the impact of asthma severity and control on labor characteristics and perinatal outcomes.
- To identify specific risks associated with asthma during pregnancy.
Main Methods:
- Utilized a Swedish national registry dataset of singleton births from July 2006 to December 2009.
- Included data on prescribed medications and physician-diagnosed asthma for the same women.
- Employed logistic regression models to estimate associations between maternal asthma and adverse outcomes.
Main Results:
- Maternal asthma (9.4% of pregnancies) was linked to increased risks of preeclampsia/eclampsia and premature contractions.
- Significant associations were found between maternal asthma and emergency cesarean sections, low birth weight, and small for gestational age.
- Adverse outcomes, such as low birth weight, showed a dose-response relationship with increasing asthma severity.
Conclusions:
- Maternal asthma is significantly associated with increased risks of serious pregnancy complications and adverse perinatal outcomes.
- Elevated asthma severity further exacerbates the likelihood of certain complications.
- Enhanced awareness and optimized asthma management during pregnancy are essential for improving maternal and infant outcomes.
Background:
Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes.
Methods:
We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression.
Results:
In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4%) pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24) and premature contractions (adj OR 1.52; 95% CI 1.29-1.80). There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34), low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33). The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes.
Conclusion:
Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.
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