Stephanie Johnston1, Joanne Said2. 1. Department of Perinatal Medicine, The Royal Women's Hospital. 2. Department of Perinatal Medicine, The Royal Women's Hospital; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.
Abstract
BACKGROUND: Asthma is one of the most common medical illnesses occurring in pregnancy and its incidence amongst the obstetric population is increasing. Previous studies have suggested that asthma is not a benign illness in pregnancy, and can contribute towards increased rates of pregnancy complications. METHODS: We undertook a retrospective audit of 6458 deliveries during 2008 at The Royal Women's Hospital to determine the perinatal outcomes for women with a self-reported diagnosis of asthma. RESULTS: We found that 501 (7.8%) deliveries were to women who identified themselves as asthmatics. Of these, 15.6% reported exacerbations of their asthma symptoms during pregnancy, with the remainder reporting improvement or stabilization. There was an increased rate of preterm birth (12.9%) in the asthmatic population, compared to the non-asthmatic population (OR = 1.48, CI [1.12-1.95], P = 0.005). Asthma remained significantly associated with an increased risk of preterm birth after adjusting for maternal smoking status using logistic regression analysis (Adjusted OR 1.41, CI [1.07-1.86], P = 0.01). Women were also at increased risk of developing pre-eclampsia (OR 1.71, CI [1.09-2.67], P = 0.02) but not fetal growth restriction. Women identifying themselves as asthmatics were also more likely to deliver by caesarean section (OR 1.32, CI [1.09-1.6], P = 0.003). CONCLUSION: These findings suggest that maternal asthma may be associated with an increased risk of preterm birth, pre-eclampsia and caesarean delivery.
BACKGROUND:Asthma is one of the most common medical illnesses occurring in pregnancy and its incidence amongst the obstetric population is increasing. Previous studies have suggested that asthma is not a benign illness in pregnancy, and can contribute towards increased rates of pregnancy complications. METHODS: We undertook a retrospective audit of 6458 deliveries during 2008 at The Royal Women's Hospital to determine the perinatal outcomes for women with a self-reported diagnosis of asthma. RESULTS: We found that 501 (7.8%) deliveries were to women who identified themselves as asthmatics. Of these, 15.6% reported exacerbations of their asthma symptoms during pregnancy, with the remainder reporting improvement or stabilization. There was an increased rate of preterm birth (12.9%) in the asthmatic population, compared to the non-asthmatic population (OR = 1.48, CI [1.12-1.95], P = 0.005). Asthma remained significantly associated with an increased risk of preterm birth after adjusting for maternal smoking status using logistic regression analysis (Adjusted OR 1.41, CI [1.07-1.86], P = 0.01). Women were also at increased risk of developing pre-eclampsia (OR 1.71, CI [1.09-2.67], P = 0.02) but not fetal growth restriction. Women identifying themselves as asthmatics were also more likely to deliver by caesarean section (OR 1.32, CI [1.09-1.6], P = 0.003). CONCLUSION: These findings suggest that maternal asthma may be associated with an increased risk of preterm birth, pre-eclampsia and caesarean delivery.
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Authors: Hooman Mirzakhani; Vincent J Carey; Thomas F McElrath; Weiliang Qiu; Bruce W Hollis; George T O'Connor; Robert S Zeiger; Leonard Bacharier; Augusto A Litonjua; Scott T Weiss Journal: Am J Respir Crit Care Med Date: 2019-01-01 Impact factor: 30.528