OBJECTIVE: To explore whether pregnancy-onset asthma leads to worse perinatal outcomes compared with pre-pregnancy asthma.
METHODS: Women who were discharged with a diagnosis of asthma and gave birth to a live singleton were included in this retrospective cohort analysis. Women were separated into groups based on whether the asthma was diagnosed during or before pregnancy. We compared clinical characteristics, perinatal outcomes, and asthma exacerbations (AEs) between groups.
RESULTS: A total of 335 women were included in this study, 39 of whom (11.6%) had pregnancy-onset asthma and 296 had pre-pregnancy asthma. All pregnant women in the pregnancy-onset group experienced AEs during pregnancy. The proportion of chronic hypertension, chronic hypertension with superimposed preeclampsia, and spontaneous preterm births in the pregnancy-onset group was significantly higher than that in the pre-pregnancy asthma group. After adjusting for age, body mass index, onset of asthma during pregnancy, and severity of AEs through multivariate analysis, pregnancy-onset asthma was an independent risk factor for spontaneous preterm birth (adjusted odds ratio = 7.71; 95% CI, 1.30-46.12) and severe AE was an independent risk factor for gestational hypertension and preeclampsia (adjusted odds ratio = 3.58; 95% CI, 1.30-9.87).
CONCLUSIONS: During pregnancy, pregnancy-onset asthma in women is associated with an exacerbation of the condition. Obstetricians should be vigilant for signs of asthma onset during pregnancy. Other health care providers should watch for symptoms of gestational hypertension and preeclampsia in pregnant women with preexisting or new-onset asthma.
目的:探讨妊娠哮喘与孕前哮喘相比是否会导致更差的围产期结局。
方法:这项回顾性队列分析包括诊断为哮喘并生下单胎的出院妇女。根据是否在怀孕期间或之前诊断出哮喘,将妇女分为几组。临床特征,围产期结局,比较两组哮喘急性发作(AE)情况。
结果:这项研究纳入了335名女性,其中39人(11.6%)患有妊娠哮喘,296人患有孕前哮喘.妊娠组的所有孕妇在怀孕期间都经历了哮喘加重(AE)。慢性高血压的比例,慢性高血压合并子痫前期,妊娠组自发性早产明显高于孕前哮喘组。在调整了年龄之后,BMI,怀孕期间哮喘发作,通过多变量分析和AE的严重程度,妊娠哮喘是自发性早产的独立危险因素(aOR7.71,95%CI1.30-46.12),重度AE是妊娠期高血压和子痫前期的独立危险因素(aOR3.58,95%CI1.30~9.87).
结论:在怀孕期间,女性妊娠性哮喘与病情加重有关.产科医生应警惕怀孕期间哮喘发作的迹象。其他卫生保健提供者应注意妊娠高血压和先发或新发哮喘孕妇先兆子痫的症状。