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Published in: Allergy, Asthma & Clinical Immunology 1/2018

Open Access 01-12-2018 | Short Report

The course of asthma during pregnancy in a recent, multicase–control study on respiratory health

Authors: A. Grosso, F. Locatelli, E. Gini, F. Albicini, C. Tirelli, I. Cerveri, A. G. Corsico

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2018

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Abstract

Background

Over the years it has been widely stated that approximately one-third of asthmatic women experience worsening of the disease during pregnancy. However, the literature has not been reviewed systematically and the meta-analytic reviews include old studies. This study aimed to examine whether the prevalence of worsening asthma during pregnancy is still consistent with prior estimate or it has been reduced.

Methods

A detailed Clinical Questionnaire on respiratory symptoms, medical history, medication, use of services, occupation, social status, home environment and lifestyle was administered to random samples of the Italian population in the frame of the Gene Environment Interactions in Respiratory Diseases (GEIRD) study. Only clinical data belong to 2.606 subjects that completed the clinical stage of the GEIRD study, were used for the present study.

Results

Out of 1.351 women, 284 self-reported asthma and 92 of them had at least one pregnancy. When we considered the asthma course during pregnancy, we found that 16 women worsened, 31 remained unchanged, 25 improved. Seven women had not the same course in the different pregnancies and 13 did not know. The starting age of ICS use almost overlaps with that of asthma onset in women with worsening asthma during pregnancy (19 years ± 1.4), unlike the other women who started to use ICS much later (30.3 years ± 12). In addition, the worsening of asthma was more frequent in women with an older age of onset of asthma (18 years ± 9 vs 13 years ± 10). Among women who completed the ACT during the clinical interview, the 50% of women who experienced worsening asthma during pregnancy (6/12) had an ACT score below 20.

Conclusion

Asthma was observed to worsen during pregnancy in a percentage much lower to that generally reported in all the previous studies. There is still room in clinical practice to further reduce worsening of asthma during pregnancy by improving asthma control, with a more structured approach to asthma education and management prepregnancy.
Literature
1.
go back to reference NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. National Heart, Lung, and Blood Institute; National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. J Allergy Clin Immunol. 2005;115:34–46. NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. National Heart, Lung, and Blood Institute; National Asthma Education and Prevention Program Asthma and Pregnancy Working Group. J Allergy Clin Immunol. 2005;115:34–46.
2.
go back to reference Louik C, Schatz M, Hernández-Díaz S, Werler MM, Mitchell AA. Asthma in pregnancy and its pharmacologic treatment. Ann Allergy Asthma Immunol. 2010;105:110–7.CrossRefPubMedPubMedCentral Louik C, Schatz M, Hernández-Díaz S, Werler MM, Mitchell AA. Asthma in pregnancy and its pharmacologic treatment. Ann Allergy Asthma Immunol. 2010;105:110–7.CrossRefPubMedPubMedCentral
3.
go back to reference Grzeskowiak LE, Smith B, Roy A, Dekker GA, Clifton VL. Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: a prospective cohort study. ERJ Open Res. 2016;2:00054–2015.CrossRefPubMedPubMedCentral Grzeskowiak LE, Smith B, Roy A, Dekker GA, Clifton VL. Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: a prospective cohort study. ERJ Open Res. 2016;2:00054–2015.CrossRefPubMedPubMedCentral
6.
go back to reference Katz O, Sheiner E. Asthma and pregnancy: a review of two decades. Expert Rev Respir Med. 2008;2:97–107.CrossRefPubMed Katz O, Sheiner E. Asthma and pregnancy: a review of two decades. Expert Rev Respir Med. 2008;2:97–107.CrossRefPubMed
7.
8.
go back to reference Schatz M. Interrelationships between asthma and pregnancy: a literature review. J Allergy Clin Immunol. 1999;103(2 Pt 2):S330–6.CrossRefPubMed Schatz M. Interrelationships between asthma and pregnancy: a literature review. J Allergy Clin Immunol. 1999;103(2 Pt 2):S330–6.CrossRefPubMed
9.
go back to reference de Marco R, Accordini S, Antonicelli L, Bellia V, Bettin MD, Bombieri C, Bonifazi F, Bugiani M, Carosso A, Casali L, Cazzoletti L, Cerveri I, Corsico AG, Ferrari M, Fois AG, Lo Cascio V, Marcon A, Marinoni A, Olivieri M, Perbellini L, Pignatti P, Pirina P, Poli A, Rolla G, Trabetti E, Verlato G, Villani S, Zanolin ME, GEIRD Study Group. The gene-environment interactions in respiratory diseases (GEIRD) project. Int Arch Allergy Immunol. 2010;152(3):255–63.CrossRefPubMed de Marco R, Accordini S, Antonicelli L, Bellia V, Bettin MD, Bombieri C, Bonifazi F, Bugiani M, Carosso A, Casali L, Cazzoletti L, Cerveri I, Corsico AG, Ferrari M, Fois AG, Lo Cascio V, Marcon A, Marinoni A, Olivieri M, Perbellini L, Pignatti P, Pirina P, Poli A, Rolla G, Trabetti E, Verlato G, Villani S, Zanolin ME, GEIRD Study Group. The gene-environment interactions in respiratory diseases (GEIRD) project. Int Arch Allergy Immunol. 2010;152(3):255–63.CrossRefPubMed
10.
go back to reference Corsico AG, Cazzoletti L, de Marco R, Janson C, Jarvis D, Zoia MC, Bugiani M, Accordini S, Villani S, Marinoni A, Gislason D, Gulsvik A, Pin I, Vermeire P, Cerveri I. Factors affecting adherence to asthma treatment in an international cohort of young and middle-aged adults. Respir Med. 2007;101(6):1363–7 Epub 2006 Dec 26.CrossRefPubMed Corsico AG, Cazzoletti L, de Marco R, Janson C, Jarvis D, Zoia MC, Bugiani M, Accordini S, Villani S, Marinoni A, Gislason D, Gulsvik A, Pin I, Vermeire P, Cerveri I. Factors affecting adherence to asthma treatment in an international cohort of young and middle-aged adults. Respir Med. 2007;101(6):1363–7 Epub 2006 Dec 26.CrossRefPubMed
11.
go back to reference Braido F, Baiardini I, Menoni S, Gani F, Senna GE, Ridolo E, Schoepf V, Rogkakou A, Canonica GW. Patients with asthma and comorbid allergic rhinitis: is optimal quality of life achievable in real life? PLoS ONE. 2012;7(2):e31178.CrossRefPubMedPubMedCentral Braido F, Baiardini I, Menoni S, Gani F, Senna GE, Ridolo E, Schoepf V, Rogkakou A, Canonica GW. Patients with asthma and comorbid allergic rhinitis: is optimal quality of life achievable in real life? PLoS ONE. 2012;7(2):e31178.CrossRefPubMedPubMedCentral
12.
go back to reference Juniper EF, Newhouse MT. Effect of pregnancy on asthma: systematic review and meta-analysis. In: Schatz M, Zeiger RS, Claman HN, editors. Asthma and immunological diseases in pregnancy and early infancy. New York: Marcel Dekker; 1993. p. 223–50. Juniper EF, Newhouse MT. Effect of pregnancy on asthma: systematic review and meta-analysis. In: Schatz M, Zeiger RS, Claman HN, editors. Asthma and immunological diseases in pregnancy and early infancy. New York: Marcel Dekker; 1993. p. 223–50.
13.
go back to reference Lim A, Stewart K, Abramson MJ, Walker SP, George J. Multidisciplinary approach to management of maternal asthma (MAMMA [copyright]): the PROTOCOL for a randomized controlled trial. BMC Public Health. 2012;12:1094.CrossRefPubMedPubMedCentral Lim A, Stewart K, Abramson MJ, Walker SP, George J. Multidisciplinary approach to management of maternal asthma (MAMMA [copyright]): the PROTOCOL for a randomized controlled trial. BMC Public Health. 2012;12:1094.CrossRefPubMedPubMedCentral
14.
go back to reference Yilmaz I, Erkekol FO, Celen S, Karaca MZ, Aydin O, Celik G, Misirligil Z, Mungan D. Does drug adherence change in asthmatic patients during pregnancy? Multidiscip Respir Med. 2013;8:38.CrossRefPubMedPubMedCentral Yilmaz I, Erkekol FO, Celen S, Karaca MZ, Aydin O, Celik G, Misirligil Z, Mungan D. Does drug adherence change in asthmatic patients during pregnancy? Multidiscip Respir Med. 2013;8:38.CrossRefPubMedPubMedCentral
15.
go back to reference Kwon HL, Belanger K, Bracken MB. Effect of pregnancy and stage of pregnancy on asthma severity: a systematic review. Am J Obstet Gynecol. 2004;190:1201e10.CrossRef Kwon HL, Belanger K, Bracken MB. Effect of pregnancy and stage of pregnancy on asthma severity: a systematic review. Am J Obstet Gynecol. 2004;190:1201e10.CrossRef
16.
go back to reference Schatz M, Dombrowski MP, Wise R, Thom EA, Landon M, Mabie W, Newman RB, Hauth JC, Lindheimer M, Caritis SN, Leveno KJ, Meis P, Miodovnik M, Wapner RJ, Paul RH, Varner MW, O’sullivan MJ, Thurnau GR, Conway D, McNellis D. Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol. 2003;112:283–8.CrossRefPubMed Schatz M, Dombrowski MP, Wise R, Thom EA, Landon M, Mabie W, Newman RB, Hauth JC, Lindheimer M, Caritis SN, Leveno KJ, Meis P, Miodovnik M, Wapner RJ, Paul RH, Varner MW, O’sullivan MJ, Thurnau GR, Conway D, McNellis D. Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol. 2003;112:283–8.CrossRefPubMed
17.
go back to reference Mirzakhani H, O’Connor G, Bacharier LB, Zeiger RS, Schatz MX, Weiss ST, Litonjua AA. Asthma control status in pregnancy, body mass index, and maternal vitamin D levels. J Allergy Clin Immunol. 2017;140:1453–6.CrossRefPubMed Mirzakhani H, O’Connor G, Bacharier LB, Zeiger RS, Schatz MX, Weiss ST, Litonjua AA. Asthma control status in pregnancy, body mass index, and maternal vitamin D levels. J Allergy Clin Immunol. 2017;140:1453–6.CrossRefPubMed
18.
go back to reference de Nijs SB, Venekamp LN, Bel EH. Adult-onset asthma: is it really different? Eur Respir Rev. 2013;22(127):44–52.CrossRefPubMed de Nijs SB, Venekamp LN, Bel EH. Adult-onset asthma: is it really different? Eur Respir Rev. 2013;22(127):44–52.CrossRefPubMed
Metadata
Title
The course of asthma during pregnancy in a recent, multicase–control study on respiratory health
Authors
A. Grosso
F. Locatelli
E. Gini
F. Albicini
C. Tirelli
I. Cerveri
A. G. Corsico
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2018
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/s13223-018-0242-0

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