Approximately 6 percent of pregnant...

Approximately 6 percent of pregnant women have asthma, making this united of the most common potentially serious medical complications of pregnancy. a certain number of studies have reported a higher rate of preterm births to asthmatic mothers, moreover these results have not been consistent, and studies have not been stratified for the severity of asthma and other factors. Dombrowski and colleagues studied the relationship of different severities of maternal asthma to preterm delivery and other adverse perinatal outcomes

This prospective, cohort studious mood involved women at 16 university medical center above a four-year period. The researchers chronicleed 906 women with mild asthma, 906 with moderate to unadorned asthma, and 928 control patients. The arranges were balanced at recruitment for smoking status and ethnicity. Exclusions from the meditation included multiple gestation, congenital abnormality in the fetus, other maternal pulmonary disease, and inability to accurately estimate gestation. Demographic and obstetric data were mustered at enrollment, and spirometry was performed forward participants with asthma. The mothers were followed each month until delivery. At each visit, forced expiratory dimensions in one second was obtained, and information was infered about symptoms and medication use.

undivided data were obtained on 866 mothers with moderate to exact asthma, 873 with mild asthma, and 881 direct patients. The rates of asthma exacerbation during follow-up in mothers with mild, moderate, and strict asthma were 12.6, 25.7, and 519 percent respectively. Overall, 23 percent of mothers reported a decrease in severity of asthma, while 303 percent reported an increase in symptom severity. No significant differences were apparent among the clumps in any pregnancy outcomes exclude for wheezing during labor and neonatal sepsis.

When pregnancy issues in mothers with severe asthma were compared with those of command patients, a significantly increased risk of gestational diabetes and delivery before 37 weeks of gestation was ground The adjusted odds ratio (OR) for gestational diabetes was 30 and that for delivery before 37 weeks of gestation was 22 The rate of cesarean delivery was also increased (OR, 16)

The authors judge that asthma is not associated with adverse pregnancy issues except for neonatal sepsis. Mothers with the mostly severe asthma appear to be at greatest risk of adverse results especially gestational diabetes, preterm delivery, and cesarean delivery.

ANNE D WALLING, MD Dombrowski MP et al. Asthma during pregnancy. Obstet Gynecol January 2004;103:5-12

EDITOR'S NOTE: The authors caution that the women studied were mainly inner-city residents and that the ends may not be applicable to all women with asthma. In addition, they monitored no other than immediate pregnancy outcomes. The long-term weights of fetal hypoxia, anti-asthma medications, and other aspects of asthma forward the infants are unknown. From a family medicine perspective, the facts that nearly 19 percent of the asthmatic mothers smok their average dead body mass index was nearly 28 and chiefly did not present for obstetric care until 19 weeks of gestation also are of interest. More prospective care is stand in want ofed to help women begin pregnancy in the healthiest condition possible.--A.D.W.

COPYRIGHT 2004 American Academy of Family Physicians

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