Vanessa E Murphy1, Megan E Jensen2, Heather Powell3, Peter G Gibson3. 1. Priority Research Centre Grow Up Well, University of Newcastle, Newcastle, New South Wales, Australia. Electronic address: vanessa.murphy@newcastle.edu.au. 2. Priority Research Centre Grow Up Well, University of Newcastle, Newcastle, New South Wales, Australia; Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia. 3. Priority Research Centre for Healthy Lungs, University of Newcastle and Hunter Medical Research Institute, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, New South Wales, Australia.
Abstract
BACKGROUND: Obesity is a risk factor for exacerbations of asthma, but the mechanisms of this effect in pregnancy are unknown. OBJECTIVE: This study determined the influence of maternal body mass index, gestational weight gain, eosinophilic inflammation, and systemic macrophage activation on the risk of exacerbations during pregnancy. METHODS: Women with asthma (n = 164) participated in the study. Body mass index recorded at baseline (17 weeks gestation) was categorized as healthy weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (>30 kg/m2). Exacerbations requiring medical intervention were recorded prospectively. Asthma control, medication use, and fractional exhaled nitric oxide were assessed monthly; additional visits occurred during exacerbations. Peripheral blood was collected at baseline for the measurement of eosinophils, soluble CD-163, C-reactive protein, and IL-6. RESULTS: Exacerbations occurred in a higher proportion of overweight (51.1%) and obese (48.4%) women compared with healthy weight women (25%; P = .026). Excess weight gain during pregnancy was not associated with exacerbation risk. Macrophage activation (elevated serum soluble CD-163) was associated with exacerbations requiring oral corticosteroids (P = .043), whereas high peripheral blood eosinophils or fractional exhaled nitric oxide were not associated with exacerbation or oral corticosteroid use. CONCLUSIONS: Being overweight or obese confers a greater risk of asthma exacerbation during pregnancy, and may be due to systemic macrophage activation.
BACKGROUND: Obesity is a risk factor for exacerbations of asthma, but the mechanisms of this effect in pregnancy are unknown. OBJECTIVE: This study determined the influence of maternal body mass index, gestational weight gain, eosinophilic inflammation, and systemic macrophage activation on the risk of exacerbations during pregnancy. METHODS:Women with asthma (n = 164) participated in the study. Body mass index recorded at baseline (17 weeks gestation) was categorized as healthy weight (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (>30 kg/m2). Exacerbations requiring medical intervention were recorded prospectively. Asthma control, medication use, and fractional exhaled nitric oxide were assessed monthly; additional visits occurred during exacerbations. Peripheral blood was collected at baseline for the measurement of eosinophils, soluble CD-163, C-reactive protein, and IL-6. RESULTS: Exacerbations occurred in a higher proportion of overweight (51.1%) and obese (48.4%) women compared with healthy weight women (25%; P = .026). Excess weight gain during pregnancy was not associated with exacerbation risk. Macrophage activation (elevated serum soluble CD-163) was associated with exacerbations requiring oral corticosteroids (P = .043), whereas high peripheral blood eosinophils or fractional exhaled nitric oxide were not associated with exacerbation or oral corticosteroid use. CONCLUSIONS: Being overweight or obese confers a greater risk of asthma exacerbation during pregnancy, and may be due to systemic macrophage activation.
Authors: Danielle R Stevens; William Grobman; Rajesh Kumar; Leah M Lipsky; Stefanie N Hinkle; Zhen Chen; Andrew Williams; Matthew C H Rohn; Jenna Kanner; Seth Sherman; Pauline Mendola Journal: Am J Epidemiol Date: 2021-05-04 Impact factor: 4.897
Authors: Danielle R Stevens; Matthew C H Rohn; Stefanie N Hinkle; Andrew D Williams; Rajesh Kumar; Leah M Lipsky; William Grobman; Seth Sherman; Jenna Kanner; Zhen Chen; Pauline Mendola Journal: PLoS One Date: 2022-04-20 Impact factor: 3.240