Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic women

Effect of maternal asthma on the risk of specific congenital malformations: A population‐based cohort study

“…A recent review article reported that induced fetal hypoxia in mammalian embryos and other animal embryos has been associated with defects such as transverse limb reduction, cleft lip and heart defects (Webster and Abela, 2007). In human studies, women with asthma with severe or uncontrolled asthma and those requiring acute care for asthma during pregnancy were found to be at increased risk of congenital malformations and this has been attributed to decreased fetal blood oxygen (Bakhireva et al, 2005;Blais and Forget, 2008). These two studies have provided useful information, but neither of them considered specific congenital malformations.…”

“…These databases have often been used in the past for epidemiologic research in the field of asthma and pregnancy (Blais et al, 2007;Blais and Forget, 2008;Breton et al, 2009;Firoozi et al, 2009;Martel et al, 2007;Martel et al, 2005). Data recorded in the RAMQ Prescription Drugs file have been compared to the prescriptions recorded in patients' medical chart and have been found to be comprehensive and to be concordant with the information recorded in medical charts (Tamblyn et al, 1995).…”

“…The maternal chronic conditions included hypertension, diabetes mellitus, epilepsy, and use of recognized teratogenic medications during the first trimester of pregnancy (Koren et al, 1998) (see Online repository-Appendix 2). Chronic hypertension, diabetes mellitus and epilepsy were identified from diagnoses or filled prescriptions of related medications recorded in the RAMQ or MED-ECHO databases one year prior or during pregnancy using specific algorithms that we developed for each condition and used in other studies (Blais et al, 2007;Blais and Forget, 2008); details of which are available upon request.…”

Respiratory diseases in pregnancy

“…8 Exacerbations during first trimester are associated with increased risk of congenital malformations. 9 Diagnosis of bronchial asthma during pregnancy is similar to that done in nonpregnant st ate, which includes history, clinical examination, and pulmonary function tests (PFT). The PFT and clinical evaluation should be done in pregnant asthmatics once in every month to assess severity and course of bronchial asthma, as severe asthma is associated with poor perinatal outcomes.…”

Use of the Control of Allergic Rhinitis and Asthma Test and pulmonary function tests to assess asthma control in pregnancy

“…5,6 Moreover, asthma exacerbations are associated with an increased risk of any congenital malformation. 7 On the other hand, when properly controlled, asthma is associated with a favourable fetal and maternal prognosis and well-controlled asthma is fundamental for an uncomplicated pregnancy and a healthy newborn. 3 A subjective assessment of asthma control has little benefit in the discrimination of controlled and uncontrolled patients and this may lead to insufficient treatment or excessive use of medication.…”