Analysis of the set of pregnancy women with asthma bronchiale

Česká verzia

Authors: J. Záhumenský; B. Zmrhalová; O. Šottner; E. Menzlová; J. Vojtěch; I. Mikysková; M. Dvořák; M. Halaška
Authors place of work: Gynekologicko-porodnická klinika 1. LF UK a FN Na Bulovce, Praha, vedoucí prof. MUDr. M. Halaška, DrSc.
Published in the journal: Ceska Gynekol 2010; 75(5): 439-442

Summary

Objective:
The set of pregnant females suffering from bronchial asthma – retrospective analysis.

Type of study:
Retrospective analysis.

Setting:
Department of Obstetrics and Gynecology, University Hospital Na Bulovce, First Medical Faculty, Charles University in Prague, Czech Republic.

Subject and method:
Our set consists of pregnant women suffering from bronchial asthma and attending our Antenatal Clinic & delivering at our Maternity Hospital from January 2008 through December 2009. Retrospective analysis of the set based on the medical records was performed.

Results:
80 females suffering from bronchial asthma gave birth at our Hospital during the studied time span, i.e. 1.7% of all deliveries at our Maternity Hospital. In 4 females (i.e. 5%) the asthma attack was observed during the pregnancy. 33% of all females suffering from bronchial asthma did not require any bronchodilator medication, 22% were just on betamimetics, 23% required inhalational betamimetics with intermittent inhalational corticosteroid and 21% use both regularly. Perorally corticosteroids or leukotrien inhibitors were not used at all. There was no negative influence on subjective felling of the female during her pregnancy and labor in 71% of cases. 24% of all females suffering from bronchial asthma delivered by Caesarean Section but just in two of them it was indicated due to the bronchial asthma itself. We observed no case of IUGR or congenital defect. No change in the length of the hospital stay in comparison to the other females was shown.

Conclusion:
The nowadays standard treatment of bronchial asthma during pregnancy is based on local inhalative bronchodilator and anti-inflammatory medication. Pregnant females are usually well compensated, and thus their perinatal outcome shows no difference compared to the healthy population.

Key words:
pregnancy, delivery, bronchial asthma.

Zdroje

1. Blais, L., Forget, A. Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic women. J Allergy Clin Immunol, 2008, 121, p. 1379-1384.

2. Bracken, MB., Triche, EW., Belanger, K., et al. Asthma symptoms, severity, and drug therapy: a prospective study of effects on 2205 pregnancies. Obstet Gynecol, 2003, 102, p. 739-752.

3. Breckler, LA., Hale, J., Jung, W., et al. Modulation of in vivo and in vitro cytokine production over the course of pregnancy in allergic and non-allergic mothers. Pediatr Allergy Immunol, 2009.

4. Breton, MC., Beauchesne, MF., Lemiere, C., et al. Risk of perinatal mortality associated with asthma during pregnancy. Thorax, 2009, 64, p. 101-106.

5. Burney, P. Asthma deaths in England and Wales 1931-85: evidence for a true increase in asthma mortality. J Epidemiol Community Health, 1988, 42, p. 316-320.

6. Burr, ML. Is asthma increasing? J Epidemiol Community Health, 1987, 41, p. 185-189.

7. Cleary, BJ., Butt, H., Strawbridge, JD., et al. Medication use in early pregnancy-prevalence and determinants of use in a prospective cohort of women. Pharmacoepidemiol Drug Saf, 2010, 19, p. 408-417.

8. Cookson, H., Granell, R., Joinson, C., et al. Mothers’ anxiety during pregnancy is associated with asthma in their children. J Allergy Clin Immunol, 2009, 123, p. 847-853.

9. Firoozi, F., Ducharme, FM., Lemiere, C., et al. Effect of fetal gender on maternal asthma exacerbations in pregnant asthmatic women. Respir Med, 2009, 103, p. 144-151.

10. Jogi, R., Janson, C., Boman, G., et al. Bronchial hyperresponsiveness in two populations with different prevalences of atopy. Int J Tuberc Lung Dis, 2004, 8, p. 1180-1185.

11. Kukla, L., Bouchalova, M., Shkiriak-Nyzhnyk, Z., et al. Chronic morbidity in women, namely in pregnancy. (Comparative study between West, Central and East European centres). Lik. Sprava, 2008, p. 43-60.

12. Litonjua, AA., Carey, VJ., Burge, HA., et al. Parental history and the risk for childhood asthma. Does mother confer more risk than father? Am J Respir Crit Care Med, 1998, 158, p. 176-181.

13. Lotvall, J., Ekerljung, L., Ronmark, EP., et al. West Sweden Asthma Study, p. prevalence trends over the last 18 years argues no recent increase in asthma. Respir Res, 2009, 10, p. 94.

14. Martel, MJ., Rey, E., Beauchesne, MF., et al. Control and severity of asthma during pregnancy are associated with asthma incidence in offspring: two-stage case-control study. Eur Respir J, 2009, 34, p. 579-587.

15. Mayhew, TM., Jenkins, H., Todd, B., et al. Maternal asthma and placental morphometry: effects of severity, treatment and fetal sex. Placenta, 2008, 29, p. 366-373.

16. Meren, M., Raukas-Kivioja, A., Jannus-Pruljan, L., et al. Low prevalence of asthma in westernizing countries-myth or reality? Prevalence of asthma in Estonia—a report from the “FinEsS” study. J Asthma, 2005, 42, p. 357-365.

17. Murphy, VE., Gibson, P., Talbot, PI., et al. Severe asthma exacerbations during pregnancy. Obstet Gynecol, 2005, 106, p. 1046-1054.

18. Nelson-Piercy, C. Asthma in pregnancy. Thorax, 2001, 56, p. 325-328.

19. Osei-Kumah, A., Wark, PA., Smith, R., et al. Asthma during pregnancy alters immune cell profile and airway epithelial chemokine release. Inflamm Res, 2009.

20. Osur, SL. The management of asthma and rhinitis during pregnancy. J Womens Health (Larchmt.), 2005, 14, p. 263-276.

21. Rey, E., Boulet, LP. Asthma in pregnancy. BMJ, 2007, 334, p. 582-585.

22. Schatz, M., Dombrowski, MP., Wise, R., et al. Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol, 2003, 112, p. 283-288.

23. Schatz, M., Harden, K., Forsythe, A., et al. The course of asthma during pregnancy, post partum, and with successive pregnancies: a prospective analysis. J Allergy Clin Immunol, 1988, 81, p. 509-517.

24. Sly, RM. Increases in deaths from asthma. Ann Allergy, 1984, 53, p. 20-25.

25. Tamasi, L., Bohacs, A., Bikov, A., et al. Exhaled nitric oxide in pregnant healthy and asthmatic women. J Asthma, 2009, 46, p. 786-791.