Acute asthma during pregnancy.

B S Stenius-Aarniala, J Hedman, K A Teramo

Department of Medicine, Helsinki University Central Hospital, Finland.

BACKGROUND: Acute asthma during pregnancy is potentially dangerous to the fetus. The aim of this study was to investigate the effect of an acute attack of asthma during pregnancy on the course of pregnancy or delivery, or the health of the newborn infant, and to identify undertreatment as a possible cause of the exacerbations. METHODS: Five hundred and four pregnant asthmatic subjects were prospectively followed and treated. The data on 47 patients with an attack of asthma during pregnancy were compared with those of 457 asthmatics with no recorded acute exacerbation and with 237 healthy parturients. RESULTS: Of 504 asthmatics, 177 patients were not initially treated with inhaled corticosteroids. Of these, 17% had an acute attack compared with only 4% of the 257 patients who had been on inhaled anti-inflammatory treatment from the start of pregnancy. There were no differences between the groups as to length of gestation, length of the third stage of labour, or amount of haemorrhage after delivery. No differences were observed between pregnancies with and without an exacerbation with regard to relative birth weight, incidence of malformations, hypoglycaemia, or need for phototherapy for jaundice during the neonatal period. CONCLUSIONS: Patients with inadequate inhaled anti-inflammatory treatment during pregnancy run a higher risk of suffering an acute attack of asthma than those treated with an anti-inflammatory agent. However, if the acute attack of asthma is relatively mild and promptly treated, it does not have a serious effect on the pregnancy, delivery, or the health of the newborn infant.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Schatz, M., Dombrowski, M. P. (2009). Asthma in Pregnancy. NEJM 360: 1862-1869 [Full Text]  
• Schatz, M. (2009). Is maternal asthma a life or death issue for the baby?. Thorax 64: 93-95 [Full Text]  
• Tata, L J, Lewis, S A, McKeever, T M, Smith, C J P, Doyle, P, Smeeth, L, Gibson, J E, Hubbard, R B (2008). Effect of maternal asthma, exacerbations and asthma medication use on congenital malformations in offspring: a UK population-based study. Thorax 63: 981-987 [Abstract] [Full Text]  
• Beckmann, C. A. (2008). Peak Flow Values by Gestation in Women With Asthma. Clin Nurs Res 17: 174-181 [Abstract]  
• Tata, L. J., Lewis, S. A., McKeever, T. M., Smith, C. J. P., Doyle, P., Smeeth, L., West, J., Hubbard, R. B. (2007). A Comprehensive Analysis of Adverse Obstetric and Pediatric Complications in Women with Asthma. Am. J. Respir. Crit. Care Med. 175: 991-997 [Abstract] [Full Text]  
• Blais, L., Beauchesne, M.-F., Rey, E., Malo, J.-L., Forget, A. (2007). Use of inhaled corticosteroids during the first trimester of pregnancy and the risk of congenital malformations among women with asthma. Thorax 62: 320-328 [Abstract] [Full Text]  
• Murphy, V E, Clifton, V L, Gibson, P G (2006). Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax 61: 169-176 [Abstract] [Full Text]  
• Murphy, V. E., Gibson, P. G., Talbot, P. I., Kessell, C. G., Clifton, V. L. (2005). Asthma self-management skills and the use of asthma education during pregnancy. Eur Respir J 26: 435-441 [Abstract] [Full Text]  
• Murphy, V. E., Gibson, P. G., Smith, R., Clifton, V. L. (2005). Asthma during pregnancy: mechanisms and treatment implications. Eur Respir J 25: 731-750 [Abstract] [Full Text]  
• Murphy, V. E., Zakar, T., Smith, R., Giles, W. B., Gibson, P. G., Clifton, V. L. (2002). Reduced 11{beta}-Hydroxysteroid Dehydrogenase Type 2 Activity Is Associated with Decreased Birth Weight Centile in Pregnancies Complicated by Asthma. J. Clin. Endocrinol. Metab. 87: 1660-1668 [Abstract] [Full Text]  
• CLIFTON, V. L., GILES, W. B., SMITH, R., BISITS, A. T., HEMPENSTALL, P. A. J., KESSELL, C. G., GIBSON, P. G. (2001). Alterations of Placental Vascular Function in Asthmatic Pregnancies. Am. J. Respir. Crit. Care Med. 164: 546-553 [Abstract] [Full Text]  
• CAMPBELL, L. A., KLOCKE, R. A. (2001). Implications for the Pregnant Patient. Am. J. Respir. Crit. Care Med. 163: 1051-1054 [Full Text]  
• Becklake, M. R, Kauffmann, F. (1999). Gender differences in airway behaviour over the human life span. Thorax 54: 1119-1138 [Full Text]  
• CYDULKA, R. K., EMERMAN, C. L., SCHREIBER, D., MOLANDER, K. H., WOODRUFF, P. G., CAMARGO, C. A. Jr. (1999). Acute Asthma among Pregnant Women Presenting to the Emergency Department. Am. J. Respir. Crit. Care Med. 160: 887-892 [Abstract] [Full Text]