Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

Abstract

Objectives To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography. Methods We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters. Results We recruited 3374 pregnant women aged 15–48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89–0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women. Conclusion This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.

Effectiveness of the combination of terbutaline and budesonide inhalation in treating acute bronchial asthma during pregnancy

“…Acute asthma symptoms develop rapidly, leading to severe conditions like dyspnea, and chest tightness. In some cases, even pneumothorax or purulent pneumothorax may ensue, and if not promptly treated, it negatively impacts the quality of life for pregnant women and poses health risks [4]. Patients with chronic persistent asthma experience recurrent symptoms that disrupt their daily lives.…”