Asthma in pregnancy: association between the Asthma Control Test and the Global Initiative for Asthma classification and comparisons with spirometry

Araujo, Georgia Véras de; Leite, Débora Farias Batista; Rizzo, José Ângelo; Sarinho, Emanuel

doi:10.1016/j.ejogrb.2016.05.010

Cited by 15 publications

(11 citation statements)

References 28 publications

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“…Thereafter, the monthly questionnaires prospectively collected information characterizing maternal asthma control status during pregnancy. The Asthma Control Test (ACT), a five‐item questionnaire included in the monthly questionnaires, was used to assess a multi‐dimensional perspective of asthma control on the basis of activity limitation, frequency of shortness of breath due to asthma, night‐time symptoms, use of rescue medication, and self‐perception of asthma control over a period of 4 weeks . An ACT score of 16 or less was considered as the cut‐off for discrimination of uncontrolled asthma from controlled asthma during pregnancy …”

Section: Methodsmentioning

confidence: 99%

Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3‐year‐old children

Mirzakhani

Carey

Zeiger

et al. 2019

Clin Experimental Allergy

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Background: While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma and the role of maternal asthma control in pregnancy on the risk for asthma in the child.Objective: We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3-year-old children and how prenatal and cord blood vitamin D status might affect this risk. Methods: Data from 806 women, their partners (biologic fathers of the infants), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrials.gov identification number NCT00920621) were used for this cohort analysis. The parental report of physician-diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for intervalcensored event times were used to estimate the main variables of interests and additional covariates on the outcome.Results: The highest risk was observed among children with both parents being asthmatic relative to non-asthmatic parents (aHR = 2.30, 95% CI: 1.35-3.84), and less so if only the mother was asthmatic (aHR = 1.70, 95% CI: 1.17-2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR = 1.60, 95% CI: 1.02-2.54).Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D ≥ 30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient cord blood vitamin D status at birth (aHR = 0.47, 95% CI: 0.27-0.83).Conclusion and Clinical Relevance: Careful attention to maternal asthma control, monitoring vitamin D status, and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze. S. T. Weiss and A. A. Litonjua contributed equally to this study.

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Section: Methodsmentioning

confidence: 99%

Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3‐year‐old children

Mirzakhani

Carey

Zeiger

et al. 2019

Clin Experimental Allergy

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“…6 There are few well-designed studies examining changes in lung function, or other objective markers of asthma or airway inflammation during pregnancy. A study from Brazil which assessed asthma control between 21 and 27 weeks' gestation among 72 pregnant women with persistent asthma found that 44% had controlled asthma according to the Global Initiative for Asthma (GINA) definition, while 78% had controlled asthma according to the Asthma Control Test, 8 indicating large variability in the assessment of asthma control during pregnancy using standard tools. There were significant relationships between the two measures of asthma control, and between asthma control and measures of lung function by spirometry.…”

Section: Asthma Control and Changes In Asthma With Pregnancymentioning

confidence: 99%

“…There were significant relationships between the two measures of asthma control, and between asthma control and measures of lung function by spirometry. 8 A study from Denmark reported that 41.6% of the cohort of 500 pregnant women had poorly controlled or uncontrolled asthma on at least one occasion. 9 The GINA definition was used, meaning that women with partly controlled asthma had daytime symptoms more than twice a week, or activity limitation of any kind, or nocturnal awakening with asthma symptoms, or use of rescue inhalers more than twice a week and/or forced expiratory volume in 1 second (FEV 1 ) < 80% predicted.…”

Section: Asthma Control and Changes In Asthma With Pregnancymentioning

confidence: 99%

“…3). 8 The concept of multidimensional assessment has been proposed for older people with asthma and chronic obstructive pulmonary disease, 76 and could be applied to pregnant women with asthma. With this approach, the multiple issues which affect health and quality of life are systematically identified, assessed, and treated, resulting in an improved outcome for the respiratory disease as well as the individual comorbidities 76,77 (►Fig.…”

Section: Management Of Comorbidities As a Component Of Asthma Managementmentioning

confidence: 99%

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Asthma during Pregnancy: Exacerbations, Management, and Health Outcomes for Mother and Infant

Murphy

Jensen

Gibson

2017

Semin Respir Crit Care Med

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One in 10 pregnant women worldwide has asthma and of these, 10% will have a severe exacerbation requiring oral corticosteroids (OCSs) in pregnancy. This review of recent publications in the field will describe the effects of exacerbation on maternal and neonatal health, the use of asthma medications during pregnancy, and will suggest novel management approaches for asthma in pregnancy. Pregnancy results in unpredictable changes in the disease; therefore, regular monitoring of symptoms is recommended. Uncontrolled asthma is frequently described in cohorts of pregnant women with asthma, and some recent studies show associations with adverse perinatal outcomes, as previously demonstrated with exacerbations. Guidelines for the management of asthma recommend the continued use of inhaled corticosteroids (ICSs) in pregnancy, with budesonide having a particularly good safety profile. Recent data suggest small effects of asthma and/or asthma medication use on congenital malformations; however, there is less data available on the safety of ICS/long-acting β agonist combinations, which are increasingly used for maintenance treatment. Novel management strategies are needed to address the complex needs of pregnant women with asthma. These include medication nonadherence and the presence of numerous comorbidities which can affect asthma, such as rhinitis, cigarette smoking, obesity, and mental health issues. Inflammation-based management has been shown to be effective in reducing exacerbations in pregnancy and may also improve perinatal outcomes. The involvement of a multidisciplinary team and the assessment of comorbidities have potential to improve the health of mothers and their offspring.

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“…В ряде исследований подтверждена высокая кор ректность АСТ в особых популяциях больных БАу курящих [11], беременных женщин [12], а также при заполнении вопросника по почте [13], через ин тернет [14] или по телефону [15]. АСТ -удобный оп росник для оценки контроля над БА в клинической практике, переведенный более чем на 80 языков.…”

Section: первичная конечная точкаunclassified

The Salford Lung Study is a way to improve asthma control in real clinical practice (a review)

Варгина¹,

Барабанова²

2017

Pulʹmonologiâ (Mosk.)

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В выборе лечения бронхиальной астмы (БА) основ ным ориентиром является достижение контроля над заболеванием и предупреждение риска будущих не благоприятных событий с использованием ступенча того подхода, предложенного современными реко мендациями [1]. Доказательная база современных клинических рекомендаций формируется прежде все го по результатам рандомизированных двойных сле пых плацебо контролируемых клинических иссле дований (РКИ), в которых предусмотрены строгие критерии отбора пациентов и распределение их слу чайным образом в группы активной терапии и конт роля, что исключает влияние на результат любых воз можных факторов, кроме исследуемого препарата [2]. УДК 616.248 085 Солфордское исследование -путь к улучшению контроля над бронхиальной астмой в реальной клинической практике (обзор клинического исследования) В.Н.Варгина, Е.Н.Барабанова ЗАО «ГлаксоСмитКляйн Трейдинг»: 121614, Москва, ул. Крылатская, 17, корп. 3 Информация об авторах Варгина Виктория Николаевна -к. м. н., медицинский менеджер респираторного направления ЗАО «ГлаксоСмитКляйн Трейдинг»; РезюмеСолфордское исследование легких в области с бронхиальной астмы (БА) (Salford Lung Study -Asthma, SLS Астма) является первым проспективным рандомизированным контролируемым клиническим исследованием, которое проводилось в условиях и в популяции, максимально соответствующих реальной клинической практике. Выявлено, что в крупной разнородной популяции больных БА лече ние комбинацией вилантерола и флутиказона фуроата (ВИ / ФФ) 22 / 92 мкг или 22 / 184 мкг 1 раз в день в порошковом ингаляторе Эллипта обеспечивало лучший контроль над заболеванием по сравнению со стандартной терапией, назначаемой и изменяемой по усмотрению врача. Уровень контроля над БА в группе ВИ / ФФ стабильно поддерживался на протяжении 12 мес., при этом изменения риска развития серьезных нежелательных явлений не выявлено. Результаты не зависели от терапии, которую исходно получали больные (ингаляционные глюкокортикостероиды или их комбинации с длительно действующими β2 агонистами), а также от статуса курения и количества обострений БА за прошедший год. Ключевые слова: бронхиальная астма, ингаляционные глюкокортикостероиды, длительно действующие β2 агонисты, вилантерол, флу тиказона фуроат, Эллипта.Для цитирования: Варгина В.Н., Барабанова Е.Н. Солфордское исследование -путь к улучшению контроля над бронхиальной астмой в реальной клинической практике (обзор клинического исследования). AbstractThe Salford Lung Study in asthma (SLS Asthma) is the first prospective, randomized, controlled clinical trial conducted in conditions and in pop ulation that were very close to real clinical practice. The study demonstrated that treatment of a large heterogeneous population of asthma patients using combination of vilanterol (VI) and fluticasone furoate (FF) (22/92 μg q.d. or 22/184 μg q.d.) via Ellipta dry powder inhaler provided better asthma control than usual maintenance therapy, continuously optimized by physician. The level of asthma control in VI/FF group was consistent ly maintained for 12 months w...

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Asthma in pregnancy: association between the Asthma Control Test and the Global Initiative for Asthma classification and comparisons with spirometry

Cited by 15 publications

References 28 publications

Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3‐year‐old children

Impact of parental asthma, prenatal maternal asthma control, and vitamin D status on risk of asthma and recurrent wheeze in 3‐year‐old children

Asthma during Pregnancy: Exacerbations, Management, and Health Outcomes for Mother and Infant

The Salford Lung Study is a way to improve asthma control in real clinical practice (a review)

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