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Fri, Feb 26, 2021
[Archive]
Spring 2021 (In Press)
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Maryam Kashanian * 
1, Arezoo HoseiniMoghaddam2, Seyyed Ali Javad Moosavi3, Narges Sheikhansari4, Hoda Abdollahi2
1, Arezoo HoseiniMoghaddam2, Seyyed Ali Javad Moosavi3, Narges Sheikhansari4, Hoda Abdollahi2
1- Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran , maryamkashanian@yahoo.com
2- Resident, Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
4- Faculty of Medicine, University of Exeter, Exeter, UK
2- Resident, Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
3- Department of Obstetrics & Gynecology, Akbarabadi Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran
4- Faculty of Medicine, University of Exeter, Exeter, UK
Abstract: (27 Views)
Background and Objective: Asthma is the most common chronic respiratory disorder during pregnancy and it may affect pregnancy outcomes. This study aims to compare the pregnancy, delivery and neonatal outcomes between asthmatic and non-asthmatic pregnant women.
Methods: The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group. Pregnancy, labor and neonatal outcomes were compared between the two groups.
Results: The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P=0.008]. Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.
Conclusion: Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.
Methods: The study was designed as a historical cohort among pregnant women with and without asthma. A total number of 583 asthmatic patients were allocated to the case group and 753 women without asthmatic history were placed in the control group. Pregnancy, labor and neonatal outcomes were compared between the two groups.
Results: The baseline characteristics of the women in both groups did not show significant differences. Gestational hypertension was more in the asthmatic group [43 (7.37%) VS 26 (3.45%), P=0.001]. Also the rate of preterm delivery was higher in asthmatic women [72 (12.34%) VS 77 (10.22%) in the control group, P=0.04]. However, the rate of preeclampsia was less in the asthmatic group [29 (4.97%) VS 71 (9.42%), P=0.008]. Apgar score at minutes 1 and 5 was less in asthmatic group. Intra Uterine Fetal Demise (IUFD) [24 (4.1%) VS 13(1.7%), P value=0.009], and neonatal death [31 (5.31%) VS 10 (1.32%), P=0.001] were more in the asthmatic group. The maternal and neonatal complications did not show significant differences in various severities of asthma. Multivariate regression model showed more risks for neonatal death [adjusted odds ratio (AOR)=4.18; CI95% 2.03-8.60], IUFD (AOR=2.43; CI95% 1.22-4.82), gestational hypertension (AOR= 1.43; CI 95% 1.40-1.45), and lower risk for preeclampsia (AOR 0.37; CI95%0.17-0.79) in asthmatic women.
Conclusion: Regardless of the fact that asthmatic mothers had higher frequencies of gestational hypertension, IUFD and neonatal death, the effect of asthma on perinatal outcome is minimal, probably because of efficient medical control.
Systematic Review: Original Research |
Subject:
Maternal Fetal Medicine
Received: 2020/11/22 | Accepted: 2021/01/10
Received: 2020/11/22 | Accepted: 2021/01/10
References
1. Giles W, Murphy V. Asthma in pregnancy: a review. Obstet Med. 2013 Jun; 6(2):58-63. [DOI:10.1258/om.2012.120008] [PMID] [PMCID]
2. Labor S, Dalbello Tir AM, Plavec D, Juric I, Roglic M, Pavkov Vukelic J, et al. What is safe enough - asthma in pregnancy - a review of current literature and recommendations. Asthma Res Pract. 2018 Dec 27; 4:11. [DOI:10.1186/s40733-018-0046-5] [PMID] [PMCID]
3. Thomsen SF, van der Sluis S, Kyvik KO, Skytthe A, Backer V. Estimates of asthma heritability in a large twin sample. Clin Exp Allergy. 2010 Jul; 40(7):1054-61. [DOI:10.1111/j.1365-2222.2010.03525.x] [PMID]
4. Tischer C, Zock JP, Valkonen M, Doekes G, Guerra S, Heederik D, et al. Predictors of microbial agents in dust and respiratory health in the Ecrhs. BMC Pulm Med 2015; 15:48. [DOI:10.1186/s12890-015-0042-y] [PMID] [PMCID]
5. Shokouhi Shoormasti R, Pourpak Z, Fazlollahi MR, Kazemnejad A, Nadali F, Ebadi Z, et al. The Prevalence of Allergic Rhinitis, Allergic Conjunctivitis, Atopic Dermatitis and Asthma among Adults of Tehran. Iran J Public Health. 2018 Nov; 47(11):1749-1755.
6. Fazlollahi MR, Najmi M, Fallahnezhad M, Sabetkish N, Kazemnejad A, Bidad K, et al. The prevalence of asthma in Iranian adults: The first national survey and the most recent updates. Clin Respir J. 2018 May; 12(5):1872-1881. [DOI:10.1111/crj.12750] [PMID]
7. Blais L, Kettani FZ, Forget A. Associations of maternal asthma severity and control with pregnancy complications. J Asthma 2014; 51(4):391-8. [DOI:10.3109/02770903.2013.879880] [PMID]
8. Rejno G, Lundholm C, Gong T, Larsson K, Saltvedt S, Almqvist C. Asthma during pregnancy in a population-based study pregnancy complications and adverse perinatal outcomes. PLoS One 2014; 9(8): e104755. [DOI:10.1371/journal.pone.0104755] [PMID] [PMCID]
9. Pali-Schöll I, Renz H, Jensen-Jarolim E. Update on allergies in pregnancy, lactation, and early childhood. J Allergy Clin Immunol. 2009 May; 123(5):1012-21. [DOI:10.1016/j.jaci.2009.01.045] [PMID] [PMCID]
10. Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia J, Gibson PG. A meta-analysis of adverse perinatal outcomes in women with asthma. BJOG. 2011 Oct; 118(11):1314-23. [DOI:10.1111/j.1471-0528.2011.03055.x] [PMID]
11. Pali-Schöll I, Namazy J, Jensen-Jarolim E. Allergic diseases and asthma in pregnancy, a secondary publication. World Allergy Organ J. 2017 Mar 2; 10(1):10. [DOI:10.1186/s40413-017-0141-8] [PMID] [PMCID]
12. Bain E, Pierides KL, Clifton VL, Hodyl NA, Stark MJ, Crowther CA, et al. Interventions for managing asthma in pregnancy. Cochrane Database Syst Rev. 2014 Oct 21; (10):CD010660. [DOI:10.1002/14651858.CD010660.pub2] [PMID] [PMCID]
13. Fazel N, Kundi M, Jensen-Jarolim E, Pali-Schöll I, Kazemzadeh A, Abdizadeh MF, et al. Prospective cohort study of pregnancy complications and birth outcomes in women with asthma. Arch Gynecol Obstet. 2018 Aug; 298(2):279-287. [DOI:10.1007/s00404-018-4800-y] [PMID] [PMCID]
14. Sheiner E, Mazor M, Levy A, Wiznitzer A, Bashiri A. Pregnancy outcome of asthmatic patients: a population-based study. J Matern Fetal Neonatal Med. 2005 Oct; 18(4):237-40. [DOI:10.1080/14767050500260616] [PMID]
15. Mendes RF, Nomura RM, Ortigosa C, Francisco RP, Zugaib M. Asthma during pregnancy: effects on fetal well-being, and maternal and perinatal complications. Rev Assoc Med Bras. 2013 Mar-Apr; 59(2):113-9. [DOI:10.1016/S2255-4823(13)70443-0]
16. Mendola P, Laughon SK, Männistö TI, Leishear K, Reddy UM, Chen Z, Zhang J. Obstetric complications among US women with asthma. Am J Obstet Gynecol. 2013 Feb; 208(2): 127.e1-8. [DOI:10.1016/j.ajog.2012.11.007] [PMID] [PMCID]
17. Vaezi A, Haghighi L, Beigmohammadi F, Nojomi M. Maternal Asthma, Pregnancy, Delivery and Birth Outcomes: A Retrospective Cohort Study. Iran J Allergy Asthma Immunol. 2017 Apr; 16(2):92-98.
18. https://www.nhlbi.nih.gov/files/docs/guidelines/asthma_qrg.pdf, and https://www.nhlbi.nih.gov/sites/default/files/media/docs/EPR- 3_Asthma_Full_Report_2007.pdf
19. Mendola P, Männistö TI, Leishear K, Reddy UM, Chen Z, Laughon SK. Neonatal health of infants born to mothers with asthma. J Allergy Clin Immunol. 2013; 133(1):85-90. e1-4. [DOI:10.1016/j.jaci.2013.06.012] [PMID] [PMCID]
20. Ali Z, Nilas L, Ulrik CS. Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma: A case control study. Respir Med. 2016 Nov; 120:124-130. [DOI:10.1016/j.rmed.2016.10.004] [PMID]
21. Rocklin RE. Asthma, asthma medications and their effects on maternal/fetal outcomes during pregnancy. Reprod Toxicol. 2011 Sep; 32(2):189-97. [DOI:10.1016/j.reprotox.2011.05.023] [PMID]
22. Baghlaf H, Spence AR, Czuzoj-Shulman N, Abenhaim HA. Pregnancy outcomes among women with asthma. J Matern Fetal Neonatal Med. 2017 Nov 22:1-7.
23. Wei J, Liu CX, Gong TT, Wu QJ, Wu L. Cigarette smoking during pregnancy and preeclampsia risk: a systematic review and meta-analysis of prospective studies. Oncotarget. 2015 Dec 22; 6(41):43667-78. [DOI:10.18632/oncotarget.6190] [PMID] [PMCID]
24. Kemppainen M, Lahesmaa-Korpinen AM, Kauppi P, Virtanen M, Virtanen SM, Karikoski R, et al. Maternal asthma is associated with increased risk of perinatal mortality. PLoS One. 2018 May 18; 13(5):e0197593. [DOI:10.1371/journal.pone.0197593] [PMID] [PMCID]
25. Trønnes H, Wilcox AJ, Markestad T, Tollånes MC, Lie RT, Moster D. Associations of maternal atopic diseases with adverse pregnancy outcomes: a national cohort study. Paediatr Perinat Epidemiol. 2014 Nov; 28(6):489-97. [DOI:10.1111/ppe.12154] [PMID] [PMCID]
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