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Factors Associated with Asthma Exacerbations During Pregnancy
Marleen P Bokern1, Annelies L Robijn2, Megan E Jensen2
1Department of Pharmaco-Therapy, Epidemiology, and Economics, University of Groningen, Groningen, The Netherlands.
The Journal of Allergy and Clinical Immunology. in Practice
|August 17, 2021
Summary
Severe asthma exacerbations during pregnancy are linked to higher doses of inhaled corticosteroids (ICS) and poor asthma control. Women with a history of exacerbations or worse asthma at the start of pregnancy face increased risks.
Area of Science:
- Obstetrics and Gynecology
- Pulmonology
- Clinical Epidemiology
Background:
- Asthma exacerbations during pregnancy can lead to adverse pregnancy outcomes.
- Identifying risk factors for these exacerbations is crucial for maternal and fetal health.
Purpose of the Study:
- To identify factors associated with asthma exacerbations in pregnant women.
- To inform clinical management and improve outcomes for pregnant individuals with asthma.
Main Methods:
- Analysis of data from three cohorts of pregnant women with asthma in Australia (2004-2019, n=1461).
- Severe exacerbations defined by hospitalization, emergency visits, or oral corticosteroid use.
- Logistic regression models used to identify significant risk factors.
Main Results:
- A medium to high dose of inhaled corticosteroids (ICS) was strongly associated with severe exacerbations (aOR=3.20).
- Worse asthma control, lack of a written asthma action plan, and prior exacerbations increased exacerbation risk.
- 9.2% of participants experienced a severe exacerbation during pregnancy.
Conclusions:
- Pre-pregnancy asthma exacerbations and poorer asthma severity at pregnancy onset predict exacerbations during pregnancy.
- Even with guideline-based treatment (GINA steps 3-4) and action plans, a significant burden of severe exacerbations persists in high-risk pregnant women.
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