Effect of maternal asthma and asthma control on pregnancy and perinatal outcomes
Effect of maternal asthma and asthma control on pregnancy and perinatal outcomes
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DOI：
10.1016/j.jaci.2007.05.044
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发表时间：
2007-09-01
影响因子：
14.2
通讯作者：
Hartert, Tina V.
中科院分区：
文献类型：
--
作者：
Enriquez, Rachel;Griffin, Marie R.;Hartert, Tina V.
工作背景：哮喘是妊娠期常见的疾病。目的：我们试图确定哮喘对不良妊娠率和胎儿结局的影响。方法：我们确定了1995年至2003年连续9年参加田纳西州医疗补助计划的15至44岁的黑人和白色妇女中的单胎妊娠，结果：在140，299例妊娠中，6.5%的孕妇患有哮喘。在患有哮喘的妇女中，23%的人去医院或急诊室就诊（哮喘加重）：40%的黑人妇女和23%的白色妇女在怀孕期间因哮喘接受医院或急诊室护理。在控制了种族和其他协变量后，哮喘妇女的婴儿出生体重平均低38 g，哮喘加重妇女的婴儿出生体重平均低56 g。哮喘单独发作和哮喘加重与妊娠期高血压疾病、膜相关疾病、早产、产前出血和剖宫产之间存在中度、剂量依赖性关系。孕产妇哮喘与早产或出生缺陷无关。结论：哮喘是妊娠几种常见不良后果的危险因素，妊娠期间哮喘控制不善会增加这些风险。临床意义：通过适当的哮喘护理，孕产妇和婴儿的结局可能会得到改善，尤其是在黑人女性中。
Background: Asthma is a common condition during pregnancy.Objective: We sought to determine the effect of asthma on the rates of adverse pregnancy and fetal outcomes.Methods: We identified pregnancies among black and white women age 15 to 44 with singleton gestations enrolled in the Tennessee Medicaid program over a period of 9 consecutive years, from 1995to 2003, and used claims data to determine the relationship of maternal asthma and asthma exacerbations on pregnancy and infant outcomes.Results: Among the 140,299 pregnancies, 6.5% were in women with asthma. Among women with asthma, 23% had a hospital or emergency department visit (exacerbated asthma): 40% of black and 23% of white women received hospital or emergency, department care for asthma during pregnancy. After controlling for race and other covariates, birth weights among infants of women with asthma were, on average, 38 g lower, and among infants of women with exacerbated asthma they were, on average, 56 g lower. There were moderate, dose-dependent relationships between asthma alone and exacerbated asthma with hypertensive disorders of pregnancy, membrane-related disorders, preterm labor, anteparturn hemorrhage, and cesarean delivery. Maternal asthma was not associated with preterm birth or birth defects.Conclusion: Asthma is a risk factor for several common adverse outcomes of pregnancy, and poorly controlled asthma during pregnancy increases these risks.Clinical implications: It is possible that both maternal and infant outcomes could be improved in this population with appropriate asthma care, especially among black women.