Asthma during pregnancy in a population-based study : pregnancy complications and adverse perinatal outcomes

BACKGROUND: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes. METHODS: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression. RESULTS: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4%) pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24) and premature contractions (adj OR 1.52; 95% CI 1.29-1.80). There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34), low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33). The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes. CONCLUSION: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.NonePublishe

Associations between moderate/severe asthma according to the Firoozi index the year before pregnancy and perinatal outcomes in a cohort of 284 214 pregnancies, mild asthma as reference.

<p>Unadjusted and adjusted model (n = 249 006) estimated by multinomial logistic regression with OR and 95% CI. In unadjusted analyses n = 8962 were included in the mild asthma group and n = 4072 in the moderate/severe group. In the adjusted analyses n = 7996 were included in the mild and n = 3646 in the moderate/severe group.</p><p>*Adjusted for age, BMI, parity, smoking at antenatal care admission, country of birth, cohabitation/marital status and level of education.</p

Asthma medication in the Medical Birth Register.

<p>a) Proportion of women with asthma medication recorded in the Medical Birth Register if asthma reported in the Medical Birth Register, National Patient Register or the Prescribed Drug Register. b) Proportion of women with asthma medication in the Medical Birth Register among those with no, mild and moderate/severe asthma according to the modified Firoozi severity index.</p

Asthma medication during trimesters.

<p>Starting and ending of treatment with asthma drugs (short-acting β2-agonists, SABA; inhaled corticosteroids, ICS and others (long-acting β2-agonists LABA and leukotriene receptor antagonist LTRA) in the Medical Birth Register.</p