| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From the Departments of Obstetrics and Gynecology at Wayne State University, Detroit, Michigan; Allergy at Kaiser Permanente, San Diego, California; Pulmonary Medicine at Johns Hopkins University, Baltimore, Maryland; the Biostatistics Center at George Washington University, Washington, DC; the National Institute of Child Health and Human Development, Bethesda, Maryland; and the Departments of Obstetrics and Gynecology at Ohio State University, Columbus, Ohio; University of Tennessee, Memphis, Tennessee; Medical College of South Carolina, Charleston, South Carolina; the University of Alabama, Birmingham, Alabama; the University of Chicago, Chicago, Illinois; the University of Pittsburgh-Magee Women’s Hospital, Pittsburgh, Pennsylvania; UT Southwestern Medical Center, Dallas Texas; Wake Forest University, Winston-Salem, North Carolina; the University of Cincinnati, Cincinnati, Ohio; Thomas Jefferson University, Philadelphia, Pennsylvania; the University of Southern California, Los Angeles, California; University of Utah, Salt Lake City, Utah; University of Miami, Miami, Florida; University of Oklahoma, Oklahoma City, Oklahoma; and the University of Texas, San Antonio, Texas.
Address reprint requests to: Mitchell P. Dombrowski, St. John Hospital, Department of Obstetrics and Gynecology, 22151 Moross Road, Suite 313, Detroit MI 48236; e-mail: Mitchell.Dombrowski{at}stjohn.org.
OBJECTIVE: To determine neonatal and maternal outcomes stratified by asthma severity during pregnancy by using the 1993 National Asthma Education Program Working Group on Asthma and Pregnancy definitions of asthma severity. The primary hypothesis was that moderate or severe asthmatics would have an increased incidence of delivery at <32 weeks of gestation compared with nonasthmatic controls.
METHODS: This was a multicenter, prospective, observational cohort study conducted over 4 years at 16 university hospital centers. Asthma severity was defined according to the National Asthma Education Program Working Group on Asthma and Pregnancy classification and modified to include medication requirements. This study had 80% power to detect a 2- to 3-fold increase in delivery less than 32 weeks of gestation among the cohort with the moderate or severe asthma compared with controls. Secondary outcome measures included obstetrical and neonatal outcomes.
RESULTS: The final analysis included 881 nonasthmatic controls, 873 with mild asthma, 814 with moderate, and 52 with severe asthma. There were no significant differences in the rates of preterm delivery less than 32 weeks (moderate or severe 3.0%, mild 3.4%, controls 3.3%; P = .873) or less than 37 weeks of gestation. There were no significant differences for neonatal outcomes except discharge diagnosis of neonatal sepsis among the mild group compared with controls, adjusted odds ratio 2.9, 95% confidence interval 1.2, 6.8. There were no significant differences for maternal complications except for an increase in overall cesarean delivery rate among the moderate-or-severe group compared with controls (adjusted odds ratio 1.4, 95% confidence interval 1.1, 1.8).
CONCLUSION: Asthma was not associated with a significant increase in preterm delivery or other adverse perinatal outcomes other than a discharge diagnosis of neonatal sepsis. Cesarean delivery rate was increased among the cohort with moderate or severe asthma.
LEVEL OF EVIDENCE: II-2
This article has been cited by other articles:
|
|
 |
|
  L. J. Tata, S. A. Lewis, T. M. McKeever, C. J. P. Smith, P. Doyle, L. Smeeth, J. West, and R. B. Hubbard A Comprehensive Analysis of Adverse Obstetric and Pediatric Complications in Women with Asthma Am. J. Respir. Crit. Care Med., May 15, 2007; 175(10): 991 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. P. Dombrowski Asthma and pregnancy. Obstet. Gynecol., September 1, 2006; 108(3): 667 - 681. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Rahimi, S Nikfar, and M Abdollahi Meta-Analysis Finds Use of Inhaled Corticosteroids During Pregnancy Safe: A Systematic Meta-Analysis Review Human and Experimental Toxicology, August 1, 2006; 25(8): 447 - 452. [Abstract] [PDF]
|
|
|
|
|
|
I. Hendler, M. Schatz, V. Momirova, R. Wise, M. Landon, W. Mabie, R. B. Newman, J. Kiley, J. C. Hauth, A. Moawad, et al. Association of Obesity With Pulmonary and Nonpulmonary Complications of Pregnancy in Asthmatic Women. Obstet. Gynecol., July 1, 2006; 108(1): 77 - 82. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. E. Murphy, P. Gibson, P. I. Talbot, and V. L. Clifton Severe Asthma Exacerbations During Pregnancy Obstet. Gynecol., November 1, 2005; 106(5): 1046 - 1054. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. E. Murphy, R. F. Johnson, Y.-C. Wang, K. Akinsanya, P. G. Gibson, R. Smith, and V. L. Clifton The Effect of Maternal Asthma on Placental and Cord Blood Protein Profiles Reproductive Sciences, July 1, 2005; 12(5): 349 - 355. [Abstract] [PDF]
|
|
|
|
 |
|
 V. E. Murphy, P. G. Gibson, R. Smith, and V. L. Clifton Asthma during pregnancy: mechanisms and treatment implications Eur. Respir. J., April 1, 2005; 25(4): 731 - 750. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. W. Triche, A. F. Saftlas, K. Belanger, B. P. Leaderer, and M. B. Bracken Association of Asthma Diagnosis, Severity, Symptoms, and Treatment With Risk of Preeclampsia Obstet. Gynecol., September 1, 2004; 104(3): 585 - 593. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Dombrowski, M. Schatz, R. Newman, and V. Momirova Asthma During Pregnancy Obstet. Gynecol., May 1, 2004; 103(5): 1002 - 1002. [Full Text] [PDF]
|
|
|
|
|
|
M. B. Bracken and E. W. Triche Asthma During Pregnancy Obstet. Gynecol., May 1, 2004; 103(5): 1001 - 1002. [Full Text] [PDF]
|
|
|
|
 |
|
 Asthma During Pregnancy: What Are the Risks? Journal Watch (General), January 30, 2004; 2004(130): 6 - 6. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
