Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis.
Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis.
复制标题
哮喘妇女妊娠的围产期结局：前瞻性对照分析。
DOI：
10.1164/ajrccm/151.4.1170
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Kagnoff,M
中科院分区：
文献类型：
--
作者：
Schatz,M;Zeiger,RS;Hoffman,CP;Harden,K;Forsythe,A;Chilingar,L;Saunders,B;Porreco,R;Sperling,W;Kagnoff,M
先前的研究发现，哮喘母亲妊娠的不良围产期结局发生率增加，但这些研究对哮喘治疗和其他混杂因素的控制不佳。本研究的目的是评估积极管理的哮喘孕妇与匹配的非哮喘对照组的围产期结局。采用起始队列设计，我们研究了486例有哮喘记录的孕妇（< 28周）和486例肺功能正常的非哮喘孕妇对照。病例组和对照组在年龄、吸烟状况、产次和分娩年份方面相匹配。采用阶梯疗法管理哮喘，以预防急性哮喘发作和干扰睡眠或正常活动的哮喘症状。慢性高血压在哮喘受试者中（3.7%）比匹配的对照组（1.0%）更常见（p = 0.007）。然而，与对照组相比，哮喘妇女妊娠期先兆子痫、围产期死亡率、早产、低出生体重儿、宫内发育迟缓或先天性畸形的发生率无显著差异。观察到需要紧急治疗或皮质类固醇的更严重哮喘与先兆子痫和低出生体重儿发病率增加之间的关系趋势，但这些相关性无统计学意义。这些数据表明，在怀孕期间积极管理哮喘的妇女的总体围产期预后与非哮喘人群相当。
Prior studies have found an increased incidence of adverse perinatal outcomes of pregnancies in asthmatic mothers, but these studies have been poorly controlled for asthma therapy and other confounding factors. The purpose of this study was to assess perinatal outcomes in actively managed pregnant asthmatic women as compared with matched nonasthmatic controls. Using an inception cohort design, we studied a volunteer sample of 486 pregnant (< 28 wk) women with documented asthma and 486 pregnant nonasthmatic controls with normal pulmonary function. Cases and controls were matched for age, smoking status, parity, and year of delivery. Asthma was managed with step therapy to prevent acute asthmatic episodes and asthma symptoms that interfered with sleep or normal activity. Chronic hypertension was significantly more common (p = 0.007) in asthmatic subjects (3.7%) than in matched controls (1.0%). However, no significant differences in incidences of preeclampsia, perinatal mortality, preterm births, low-birth-weight infants, intrauterine growth retardation, or congenital malformations were observed in the pregnancies of the asthmatic women as compared with the matched controls. Trends were observed toward relationships between more severe asthma requiring emergency therapy or corticosteroids and increased incidences of preeclampsia and low-birth-weight infants, but these associations were not statistically significant. These data suggest that the overall perinatal prognosis for women with actively managed asthma during pregnancy is comparable to that for the nonasthmatic population.