Maternal beliefs and asthma medication adherence during pregnancy

Maintaining optimal control of asthma during pregnancy is critical, as poorly controlled asthma is associated with negative health implications for both mother and baby. However, asthma medications are frequently discontinued by patients during pregnancy.

This study aimed to examine maternal beliefs, maternal characteristics, and infant birth outcomes associated with asthma medication nonadherence during pregnancy.

Between 2014 and 2022, pregnant asthmatic women were invited to respond to a 29-question asthma adherence survey. Using the t test, chi-square test, or Fisher exact test, we compared maternal characteristics and beliefs about asthma medications between those survey respondents with more reported adherence and those survey respondents with less reported adherence. Additionally, we used logistic regression with adjustment for select covariates to compare birth outcomes between those survey participants with more and those participants with less adherence.

Of the 341 participants who responded to the asthma medication adherence question, 40 (11.7%) reported less adherence. Less adherence was associated with agreement with the statement that taking asthma medications in pregnancy is unsafe (P = .001), concern that a preventive/controller medication would harm the baby (P = .003), and disagreement with the belief that asthma medication is effective in controlling symptoms in pregnancy (P = .021). Less adherence was not associated with preterm delivery (odds ratio [OR] = 0.54 [95% CI = 0.12-2.38]), small for gestational age from the standpoint of birth weight (adjusted OR = 0.31 [95% CI = 0.06-1.76]), or small for gestational age from the standpoint of birth length (adjusted OR = 0.45 [95% CI = 0.05-4.43]).

Although we did not find an association between any maternal characteristics and asthma adherence, concerns about the safety and efficacy of asthma medication were significantly associated with asthma medication adherence.