Background: Thirteen studies investigating the association between asthma during pregnancy and perinatal mortality reported generally no increased risk. Most of these studies should be interpreted with caution because they were limited in terms of statistical power.
Objective: To evaluate whether maternal asthma during pregnancy increases the risk of perinatal mortality.
Methods: Through three administrative databases from Québec (Canada), we formed a cohort including asthmatic and non-asthmatic women who had at least one pregnancy between 1990 and 2002. Perinatal mortality was identified through diagnostic codes. We estimated the adjusted odds ratio of perinatal mortality comparing asthmatic and non-asthmatic women with Generalized Estimation Equations (GEE) models. The first model included all potential confounders (except SGA) while the second model excluded birth weight, gestational age at birth and SGA and the third model excluded birth weight, gestational age at birth but included only SGA. This analysis was also stratified for birth weight and gestational age at birth.
Results: The cohort was formed of 13 100 and 28 042 single pregnancies from asthmatic and non-asthmatic women. The crude OR of perinatal mortality was 1.35, 95% CI (1.08-1.67). The OR decreased to 0.93 (95% CI: 0.75-1.17) after adjustment for birth weight and gestational age at birth. Asthmatic women had a higher rate of low birth weight baby and preterm delivery compared to non-asthmatic.
Conclusion: The increased risk of low birth weight baby and premature delivery among asthmatic women may partly explain the association between maternal asthma and the increased risk of perinatal mortality.
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