Does maternal asthma contribute to racial/ethnic disparities in obstetrical and neonatal complications?

Abstract

Purpose Examine whether maternal asthma contributes to racial/ethnic differences in obstetric and neonatal complications. Methods Data on White (n=110,603), Black (n=50,284) and Hispanic (n=38,831) singleton deliveries came from the Consortium on Safe Labor. Multi-level logistic regression models, with an interaction term for asthma and race/ethnicity, estimated within-group adjusted odds ratios (aOR) for gestational diabetes, gestational hypertension, preeclampsia, placental abruption, premature rupture of membranes, preterm delivery, maternal hemorrhage, NICU admissions, small for gestational age (SGA), apnea, respiratory distress syndrome, transient tachypnea of the newborn, anemia and hyperbilirubinemia after adjustment for clinical and demographic confounders. Non-asthmatics of the same racial/ethnic group were the reference group. Results Compared to non-asthmatics, White asthmatics had increased odds of preeclampsia (aOR 1.28; 95% CI: 1.15–1.43) and maternal hemorrhage (1.14; 1.04–1.23). White and Hispanic infants were more likely to have NICU admissions (1.19; 1.11–1.28; 1.16; 1.02–1.32, respectively) and be SGA (1.11; 1.02–1.20; 1.26; 1.10–1.44, respectively) and Hispanic infants were more likely to have apnea (1.32; 1.02–1.69). Conclusions Maternal asthma did not impact most obstetric and neonatal complication risks within racial/ethnic groups. Despite their increased risk for both asthma and many complications, our findings for Black women were null. Asthma did not contribute to racial/ethnic disparities in complications.

Determining the Clinical Course of Asthma in Pregnancy

“…1 Compared with women without asthma, women with asthma are more likely to experience adverse pregnancy outcomes including preterm delivery, a Abbreviations used FVC-forced vital capacity gestational diabetes, preeclampsia, and neonatal death. [2][3][4][5][6] Previous studies suggest that better asthma control during pregnancy may help to ameliorate some of these outcomes. 2,7 Convention holds that a third of women with asthma will experience increased control (ie, get better), a third will experience no change in control (ie, stay the same), and a third will experience decreased control (ie, get worse) during pregnancy.…”

Maternal Racial Origin and Preeclampsia: Cohort Study and Systematic Review With Meta-Analysis

“…3 Studies from countries with populations that are of predominantly white racial origin have consistently reported that in minority groups, such as women of black racial origin, the incidence of PE is increased. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] In a small number of studies the incidence of PE in women of East Asian racial origin tended to be lower than in white women, whereas in South Asian women the incidence tended to be similar to that in white women. 9,12,15,16,[20][21][22] However, in most of these studies the observed relative incidence of PE was not adjusted for confounding factors in maternal characteristics and medical history.…”

“…The search identified 3,654 potentially relevant citations, but 3,635 were excluded because they were nonrelevant articles, abstracts or letters rather than peer-reviewed papers, case-control studies, review articles, opinions or guidelines, studies providing data on a mixture of singleton and twin pregnancies or a mixture of PE and GH, and studies on parts of the same population (Figure 1). In total, only 19 studies were considered to be relevant and their data were combined with ours for the meta-analysis [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . All 20 studies reported on PE in white women, 17 in black women, 8 on South Asian women and 6 on East Asian women.…”

Influences of Maternal Factors Over Offspring Allergies and the Application for Food Allergy

“…The analysis of genetic markers for the ancestry suggests that the racial disparities and ancestry are associated with elevated levels of food allergen-specific IgE (139). The effects of maternal asthma on racial/ethnic disparities in obstetrical and neonatal complications were tested (91). Analysis of data acquired from white ( N = 110,603), black ( N = 50,284), and Hispanic ( N = 38,831) singleton for joint effects of maternal race/ethnicity and asthma on the odds of obstetrical/neonatal complications indicated that maternal asthma status did not confer additional risks for asthma or complications (preeclampsia, neonatal intensive care unit admissions, maternal hemorrhage, small for gestational age, and apnea) to black women and their infants, while maternal asthma status increased risk for both asthma and many complications to white and Hispanic (91).…”