Skip to main content
Top
Published in: Maternal and Child Health Journal 2/2012

01-02-2012

The Moderating Influence of Asthma Diagnosis on Biobehavioral Health Characteristics of Women of Reproductive Age

Authors: RyaLynn M. Carter, Danielle Symons Downs, Rebecca Bascom, Anne-Marie Dyer, Carol S. Weisman

Published in: Maternal and Child Health Journal | Issue 2/2012

Login to get access

Abstract

Promoting healthy behaviors to improve pregnancy outcomes requires an understanding of the factors influencing health behaviors among at-risk populations. We hypothesized that women with an asthma diagnosis would have poorer biobehavioral health risk factors and pregnancy outcomes compared to women without an asthma diagnosis. The Central Pennsylvania Women’s Health Study (CePAWHS) included a population-based survey examining health status indicators, risk factors and outcomes, and detailed pregnancy histories among 2,002 women (ages 18–45). 213 asthmatics were identified. Compared with Non-asthmatic women (NA), Asthmatic (A) women reported lower rates of excellent health status (45% A vs. 65% NA, P < 0.001), were more likely to be overweight or obese (68% A vs. 50% NA, P < 0.001), and were more likely to have smoked cigarettes during their first pregnancy (25% A vs. 17% NA, P < 0.01). Psychological measures (psychosocial hassles, low self-esteem, depression) were reported more often in asthmatics than non-asthmatics. Also, asthmatics reported a higher incidence of gestational diabetes (10% A vs. 6% of NA, P = 0.05), preterm births (25% A vs. 16% NA, P < 0.01), and had a higher proportion of low birth weight infants (20% A vs. 13% NA, P = 0.03) compared with non-asthmatics. As predicted, asthmatics had poorer biobehavioral risk factors and outcomes compared to non-asthmatics. These findings illustrate the need to target asthmatic women of reproductive age, particularly in this largely rural setting, with interventions to reduce biobehavioral risk factors as part of a strategy to improve pregnancy outcomes.
Literature
1.
go back to reference Kwon, H. L., Belanger, K., & Bracken, M. B. (2003). Asthma prevalence among pregnant and childbearing-aged women in the United States: Estimates from national health surveys. Annals of Epidemiology, 13(5), 317–324.PubMedCrossRef Kwon, H. L., Belanger, K., & Bracken, M. B. (2003). Asthma prevalence among pregnant and childbearing-aged women in the United States: Estimates from national health surveys. Annals of Epidemiology, 13(5), 317–324.PubMedCrossRef
2.
go back to reference National Asthma Education and Prevention Program (NAEPP). (2004). In National Institutes of Health (Ed.), Managing asthma during pregnancy: Recommendations for pharmacologic treatment—update. U.S. Department of Health and Human Services. National Asthma Education and Prevention Program (NAEPP). (2004). In National Institutes of Health (Ed.), Managing asthma during pregnancy: Recommendations for pharmacologic treatmentupdate. U.S. Department of Health and Human Services.
3.
go back to reference Kwon HL, T. E., Belanger, K., & Bracken, M. B. (2006). The epidemiology of asthma during pregnancy: Prevalence, diagnosis, and symptoms. Immunology and Allergy Clinics of North America, 26(1), 29–62.PubMedCrossRef Kwon HL, T. E., Belanger, K., & Bracken, M. B. (2006). The epidemiology of asthma during pregnancy: Prevalence, diagnosis, and symptoms. Immunology and Allergy Clinics of North America, 26(1), 29–62.PubMedCrossRef
4.
go back to reference Murphy, V. E., Gibson, P., Talbot, P. I., & Clifton, V. L. (2005). Severe asthma exacerbations during pregnancy. Obstetrics and Gynecology, 106(5 Pt 1), 1046–1054.PubMedCrossRef Murphy, V. E., Gibson, P., Talbot, P. I., & Clifton, V. L. (2005). Severe asthma exacerbations during pregnancy. Obstetrics and Gynecology, 106(5 Pt 1), 1046–1054.PubMedCrossRef
5.
go back to reference Murphy, V. E., Clifton, V., & Gibson, P. G. (2006). Asthma exacerbations during pregnancy: Incidence and association with adverse pregnancy outcomes. Thorax, 61(2), 169–176.PubMedCrossRef Murphy, V. E., Clifton, V., & Gibson, P. G. (2006). Asthma exacerbations during pregnancy: Incidence and association with adverse pregnancy outcomes. Thorax, 61(2), 169–176.PubMedCrossRef
6.
go back to reference Schatz, M., & Dombrowski, M. (2009). Asthma in pregnancy. New England Journal of Medicine, 360, 1862–1869.PubMedCrossRef Schatz, M., & Dombrowski, M. (2009). Asthma in pregnancy. New England Journal of Medicine, 360, 1862–1869.PubMedCrossRef
7.
go back to reference Hendler, I., Schatz, M., Momirova, V., Wise, R., Landon, M., Mabie, W., et al. (2006). Association of obesity with pulmonary and nonpulmonary complications of pregnancy in asthmatic women. Obstetrics and Gynecology, 108(1), 77–82.PubMedCrossRef Hendler, I., Schatz, M., Momirova, V., Wise, R., Landon, M., Mabie, W., et al. (2006). Association of obesity with pulmonary and nonpulmonary complications of pregnancy in asthmatic women. Obstetrics and Gynecology, 108(1), 77–82.PubMedCrossRef
8.
go back to reference Eberhardt, M. S., Ingram, D., & Makuc, D. M. (2001). Health United States 2001. Urban and rural health chartbook. Hyattsville, MD: National Center for Health Statistics. Eberhardt, M. S., Ingram, D., & Makuc, D. M. (2001). Health United States 2001. Urban and rural health chartbook. Hyattsville, MD: National Center for Health Statistics.
9.
go back to reference Hartley, D. (2004). Rural health disparities, population health, and rural culture. American Journal of Public Health, 94(10), 1675–1678.PubMedCrossRef Hartley, D. (2004). Rural health disparities, population health, and rural culture. American Journal of Public Health, 94(10), 1675–1678.PubMedCrossRef
10.
go back to reference National Heart, Lung, and Blood Institute, National Asthma Education Program. (1991). In Department of Health and Human Services (Ed.), Expert panel report: Guidelines for the diagnosis and management of asthma. NIH. National Heart, Lung, and Blood Institute, National Asthma Education Program. (1991). In Department of Health and Human Services (Ed.), Expert panel report: Guidelines for the diagnosis and management of asthma. NIH.
11.
go back to reference Demissie, K., Breckenridge, M., & Rhoads, G. G. (1998). Infant and maternal outcomes in the pregnancies of asthmatic women. American Journal of Respiratory and Critical Care Medicine, 158(4), 1091–1095.PubMed Demissie, K., Breckenridge, M., & Rhoads, G. G. (1998). Infant and maternal outcomes in the pregnancies of asthmatic women. American Journal of Respiratory and Critical Care Medicine, 158(4), 1091–1095.PubMed
12.
go back to reference Liu, S., Wen, S., Demissie, K., Marcoux, S., & Kramer, M. S. (2001). Maternal asthma and pregnancy outcomes: a retrospective cohort study. American Journal of Obstetrics and Gynecology, 184(2), 90–96.PubMedCrossRef Liu, S., Wen, S., Demissie, K., Marcoux, S., & Kramer, M. S. (2001). Maternal asthma and pregnancy outcomes: a retrospective cohort study. American Journal of Obstetrics and Gynecology, 184(2), 90–96.PubMedCrossRef
13.
go back to reference Whitty, J., & Dombrowski, M. P. (2004). Chapter 46: Respiratory diseases in pregnancy. In R. Crease & R. Resnik (Eds.), Maternal fetal medicine, principles and practice (pp. 953–974). Philadelphia: Saunders. Whitty, J., & Dombrowski, M. P. (2004). Chapter 46: Respiratory diseases in pregnancy. In R. Crease & R. Resnik (Eds.), Maternal fetal medicine, principles and practice (pp. 953–974). Philadelphia: Saunders.
14.
go back to reference Kwon, H. L., Belanger, K., & Bracken, M. B. (2004). Effect of pregnancy and stage of pregnancy on asthma severity: A systematic review. American Journal of Obstetrics and Gynecology, 190(5), 1201–1210.PubMedCrossRef Kwon, H. L., Belanger, K., & Bracken, M. B. (2004). Effect of pregnancy and stage of pregnancy on asthma severity: A systematic review. American Journal of Obstetrics and Gynecology, 190(5), 1201–1210.PubMedCrossRef
15.
go back to reference Bracken, M., Triche, E. W., Belanger, K., Saftlas, A., Beckett, W. S., & Leaderer, B. P. (2003). Asthma symptoms, severity and drug therapy: A prospective study of effects on 2205 pregnancies. Obstetrics and Gynecology, 102, 739–752.PubMedCrossRef Bracken, M., Triche, E. W., Belanger, K., Saftlas, A., Beckett, W. S., & Leaderer, B. P. (2003). Asthma symptoms, severity and drug therapy: A prospective study of effects on 2205 pregnancies. Obstetrics and Gynecology, 102, 739–752.PubMedCrossRef
16.
go back to reference Castro LC, A. R. (2002). Maternal obesity and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology, 14(6), 601–606.PubMedCrossRef Castro LC, A. R. (2002). Maternal obesity and pregnancy outcomes. Current Opinion in Obstetrics and Gynecology, 14(6), 601–606.PubMedCrossRef
17.
go back to reference Schatz, M., Dombrowski, M., Wise, R., Momirova, V., Landon, M., Mabie, W., et al. (2004). The relationship of asthma medication use to perinatal outcomes. Journal of Allergy and Clinical Immunology, 113, 1040–1045.PubMedCrossRef Schatz, M., Dombrowski, M., Wise, R., Momirova, V., Landon, M., Mabie, W., et al. (2004). The relationship of asthma medication use to perinatal outcomes. Journal of Allergy and Clinical Immunology, 113, 1040–1045.PubMedCrossRef
18.
go back to reference Schneider, S., & Schütz, J. (2008). Who smokes during pregnancy? A systematic literature review of population-based surveys conducted in developed countries between 1997 and 2006. European Journal of Contraception Reproductive Health Care, 13(2), 138–147.PubMedCrossRef Schneider, S., & Schütz, J. (2008). Who smokes during pregnancy? A systematic literature review of population-based surveys conducted in developed countries between 1997 and 2006. European Journal of Contraception Reproductive Health Care, 13(2), 138–147.PubMedCrossRef
19.
go back to reference Weisman CS, H. M., Chase, G. A., Dyer, A. M., Baker, S. A., Feinberg, M., Symons Downs, D., et al. (2006). Preconceptional health: Risks of adverse pregnancy outcomes by reproductive life stage in the Central Pennsylvania Women’s Health Study (CePAWHS). Womens Health Issues, 16(4), 216–224.PubMedCrossRef Weisman CS, H. M., Chase, G. A., Dyer, A. M., Baker, S. A., Feinberg, M., Symons Downs, D., et al. (2006). Preconceptional health: Risks of adverse pregnancy outcomes by reproductive life stage in the Central Pennsylvania Women’s Health Study (CePAWHS). Womens Health Issues, 16(4), 216–224.PubMedCrossRef
20.
go back to reference American College of Sports Medicine. (2000). Guidelines for exercise testing, prescription (6th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. American College of Sports Medicine. (2000). Guidelines for exercise testing, prescription (6th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
21.
go back to reference Curry, M. A., Campbell, R., & Christian, M. (1994). Validity and reliability testing of the prenatal psychosocial profile. Research in Nursing and Health, 17(2), 127–135.PubMedCrossRef Curry, M. A., Campbell, R., & Christian, M. (1994). Validity and reliability testing of the prenatal psychosocial profile. Research in Nursing and Health, 17(2), 127–135.PubMedCrossRef
22.
go back to reference Rosenberg, M. (1965). Society, the adolescent self-image. Princeton, NJ: Princeton University Press. Rosenberg, M. (1965). Society, the adolescent self-image. Princeton, NJ: Princeton University Press.
23.
go back to reference Radloff, L. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRef Radloff, L. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRef
24.
go back to reference Sherbourne, C. D., Dwight-Johnson, M., & Klap, R. (2001). Psychological distress, unmet need, and barriers to mental health care for women. Womens Health Issues, 11(3), 231–243.PubMedCrossRef Sherbourne, C. D., Dwight-Johnson, M., & Klap, R. (2001). Psychological distress, unmet need, and barriers to mental health care for women. Womens Health Issues, 11(3), 231–243.PubMedCrossRef
25.
go back to reference National Center for Health Statistics. (1994). Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–1994. In Vital Health Statistics (Ed.), Series 1. Hyattsville, MD. National Center for Health Statistics. (1994). Plan and operation of the Third National Health and Nutrition Examination Survey, 1988–1994. In Vital Health Statistics (Ed.), Series 1. Hyattsville, MD.
26.
go back to reference National Center for Health Statistics. (2000). Design and estimation for the National Health Interview Survey, 1995–2004. In National Center for Health Statistics (Ed.) Vital and Health Statistic. Hyattsville, MD. National Center for Health Statistics. (2000). Design and estimation for the National Health Interview Survey, 1995–2004. In National Center for Health Statistics (Ed.) Vital and Health Statistic. Hyattsville, MD.
27.
go back to reference Prevention, C.f.D.C.a. (1998). Behavioral risk factor surveillance system user’s guide. Atlanta, GA: Centers for Disease Control and Prevention. Prevention, C.f.D.C.a. (1998). Behavioral risk factor surveillance system user’s guide. Atlanta, GA: Centers for Disease Control and Prevention.
28.
go back to reference CDC, C.f.D.C.a.P. (2007). Cigarette smoking among adults—United States, 2006. MMWR—Morbidity & Mortality Weekly Report, 56(44), 1157–1161. CDC, C.f.D.C.a.P. (2007). Cigarette smoking among adultsUnited States, 2006. MMWR—Morbidity & Mortality Weekly Report, 56(44), 1157–1161.
29.
go back to reference Ford, E. S., & Mannino, D. (2005). Time trends in obesity among adults with asthma in the United States: Findings from three national surveys. Journal of Asthma, 42(2), 91–95.PubMedCrossRef Ford, E. S., & Mannino, D. (2005). Time trends in obesity among adults with asthma in the United States: Findings from three national surveys. Journal of Asthma, 42(2), 91–95.PubMedCrossRef
30.
go back to reference Romieu, I., Mannino, D., Redd, S. C., & McGeehin, M. A. (2004). Dietary intake, physical activity, body mass index, and childhood asthma in the Third National Health and Nutrition Survey (NHANES III). Pediatric Pulmonology, 38(1), 31–42.PubMedCrossRef Romieu, I., Mannino, D., Redd, S. C., & McGeehin, M. A. (2004). Dietary intake, physical activity, body mass index, and childhood asthma in the Third National Health and Nutrition Survey (NHANES III). Pediatric Pulmonology, 38(1), 31–42.PubMedCrossRef
31.
go back to reference Weiss, J. L., Malone, F., Emig, D., Ball, R. H., Nyberg, D. A., Comstock, C. H., et al. (2004). Obesity, obstetric complications and cesarean delivery rate—a population-based screening study. American Journal of Obstetrics and Gynecology, 190(4), 1091–1097.PubMedCrossRef Weiss, J. L., Malone, F., Emig, D., Ball, R. H., Nyberg, D. A., Comstock, C. H., et al. (2004). Obesity, obstetric complications and cesarean delivery rate—a population-based screening study. American Journal of Obstetrics and Gynecology, 190(4), 1091–1097.PubMedCrossRef
32.
go back to reference Roelands, J., Jamison, M., Lyerly, A. D., & James, A. H. (2009). Consequences of smoking during pregnancy on maternal health. Journal of Womens Health, 18(6), 167–172.CrossRef Roelands, J., Jamison, M., Lyerly, A. D., & James, A. H. (2009). Consequences of smoking during pregnancy on maternal health. Journal of Womens Health, 18(6), 167–172.CrossRef
33.
go back to reference Kaiser, L. L., Allen, L., & American Dietetic Association. (2002). Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. Journal of the American Dietetic Association, 102(10), 1479–1490.PubMedCrossRef Kaiser, L. L., Allen, L., & American Dietetic Association. (2002). Position of the American Dietetic Association: Nutrition and lifestyle for a healthy pregnancy outcome. Journal of the American Dietetic Association, 102(10), 1479–1490.PubMedCrossRef
34.
go back to reference Camargo, C. A., Jr, Weiss, S., Zhang, S., Willett, W. C., & Speizer, F. E. (1999). Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Archives of Internal Medicine, 159(21), 2582–2588.PubMedCrossRef Camargo, C. A., Jr, Weiss, S., Zhang, S., Willett, W. C., & Speizer, F. E. (1999). Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Archives of Internal Medicine, 159(21), 2582–2588.PubMedCrossRef
35.
go back to reference Luder, E., Ehrlich, R., Lou, W. Y., Melnik, T. A., & Kattan, M. (2004). Body mass index and the risk of asthma in adults. Respiratory Medicine, 98(1), 29–37.PubMedCrossRef Luder, E., Ehrlich, R., Lou, W. Y., Melnik, T. A., & Kattan, M. (2004). Body mass index and the risk of asthma in adults. Respiratory Medicine, 98(1), 29–37.PubMedCrossRef
36.
go back to reference Ford, E. S., Hagan, G., Mannino, D. M., & Redd, S. C. (2003). Leisure-time physical activity patterns among US adults with asthma. Chest, 124(2), 421–422.CrossRef Ford, E. S., Hagan, G., Mannino, D. M., & Redd, S. C. (2003). Leisure-time physical activity patterns among US adults with asthma. Chest, 124(2), 421–422.CrossRef
37.
go back to reference Westermann, H., Choi, T., Briggs, W. M., Charlson, M. E., & Mancuso, C. A. (2008). Obesity and exercise habits of asthmatic patients. Annals of Allergy, Asthma & Immunology, 101(5), 488–494.CrossRef Westermann, H., Choi, T., Briggs, W. M., Charlson, M. E., & Mancuso, C. A. (2008). Obesity and exercise habits of asthmatic patients. Annals of Allergy, Asthma & Immunology, 101(5), 488–494.CrossRef
39.
go back to reference American College of Obstetricians and Gynecologists. (2002). Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. Obstetrics & Gynecology, 99, 171–173. American College of Obstetricians and Gynecologists. (2002). Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. Obstetrics & Gynecology, 99, 171–173.
40.
go back to reference Strine, T. W., Mokdad, A., Balluz, L. S., Gonzalez, O., Crider, R., Berry, J. T., et al. (2008). Depression and anxiety in the United States: Findings from the 2006 behavioral risk factor surveillance system. Psychiatric Services, 59(12), 1383–1390.PubMedCrossRef Strine, T. W., Mokdad, A., Balluz, L. S., Gonzalez, O., Crider, R., Berry, J. T., et al. (2008). Depression and anxiety in the United States: Findings from the 2006 behavioral risk factor surveillance system. Psychiatric Services, 59(12), 1383–1390.PubMedCrossRef
41.
go back to reference Deshmukha, V., Toelle, B., Usherwoodb, T., O’Gradyc, B., & Jenkinsa, C. (2007). Anxiety, panic and adult asthma: A cognitive-behavioral perspective. Respiratory Medicine, 101(2), 194–202.CrossRef Deshmukha, V., Toelle, B., Usherwoodb, T., O’Gradyc, B., & Jenkinsa, C. (2007). Anxiety, panic and adult asthma: A cognitive-behavioral perspective. Respiratory Medicine, 101(2), 194–202.CrossRef
42.
go back to reference American College of Obstetricians and Gynecologists. (2006). Psychosocial risk factors: perinatal screening and intervention. Obstetrics and Gynecology 469–747. American College of Obstetricians and Gynecologists. (2006). Psychosocial risk factors: perinatal screening and intervention. Obstetrics and Gynecology 469–747.
43.
go back to reference Dombrowski, M. P., Schatz, M., Wise, R., Momirova, V., Landon, M., Mabie, W., et al. (2004). Asthma during pregnancy. Obstetrics and Gynecology, 103(1), 5–12. Dombrowski, M. P., Schatz, M., Wise, R., Momirova, V., Landon, M., Mabie, W., et al. (2004). Asthma during pregnancy. Obstetrics and Gynecology, 103(1), 5–12.
44.
go back to reference Dombrowski, M. (2000). Should the definitions of asthma severity be modified during pregnancy? American Journal of Obstetrics and Gynecology, 182(S167). Dombrowski, M. (2000). Should the definitions of asthma severity be modified during pregnancy? American Journal of Obstetrics and Gynecology, 182(S167).
Metadata
Title
The Moderating Influence of Asthma Diagnosis on Biobehavioral Health Characteristics of Women of Reproductive Age
Authors
RyaLynn M. Carter
Danielle Symons Downs
Rebecca Bascom
Anne-Marie Dyer
Carol S. Weisman
Publication date
01-02-2012
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 2/2012
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-011-0749-1

Other articles of this Issue 2/2012

Maternal and Child Health Journal 2/2012 Go to the issue