Longitudinal study of lung function in pregnant women: Influence of parity and smoking

Abstract

OBJECTIVES:To evaluate pulmonary function in the first and third trimesters of pregnancy and analyze the influence of parity and smoking on spirometry parameters.METHODS:This longitudinal prospective study included a cohort of 120 pregnant women. The inclusion criteria were as follows: singleton pregnancy, gestational age less than 13.86 weeks, and no preexisting maternal diseases. The exclusion criteria were as follows: change of address, abortion, and inadequate spirometry testing. ClinicalTrials.gov: NCT02807038.RESULTS:A decrease in values of forced vital capacity and forced expiratory volume were noted in the first second from the first to third trimester. In the first and third trimesters, multiparous women demonstrated lower absolute forced vital capacity and forced expiratory volume values in the first second compared with nulliparous women (p<0.0001 and p=0.001, respectively). Multiparous women demonstrated reduced forced expiratory flow in 25% to 75% of the maneuver compared with nulliparous women in the first (p=0.005) and third (p=0.031) trimesters. The absolute values of forced expiratory flow in 25% to 75%, forced expiratory volume in the first second and predicted peak expiratory flow values in the third trimester were higher in smokers compared with nonsmokers (p=0.042, p=0.039, p=0.024, and p=0.021, respectively).CONCLUSION:There was a significant reduction in forced vital capacity and forced expiratory volume values in the first second during pregnancy. Parity and smoking significantly influence spirometric variables.

The impacts of parity on lung function data (LFD) of healthy females aged 40 years and more issued from an upper middle income country (Algeria): A comparative study

“…Fourthly, a North-African study showed that high parity leads to a decrease in total airway conductance [6]. On the other hand, the present study findings related to FEV 1 FVC and peripheral airway flows (Table 2) are partially opposite with these of others concluding that multiparity negatively impacts LFD [6, 7, 12, 13, 15] (S2 File). First, a study including females aged ≥ 60 years [7], concluded that compared to females with a parity ≤ 4, those with a parity > 4 had lower FEV 1 , FEV 1 /FVC, MMEF and PEF.…”

“…Secondly, another study including females aged ≥ 40 years [6], concluded that multiparity leads to a tendency towards an OVD with a decrease in FEV 1 /FVC. Thirdly, compared to Brazilian nulliparous females aged < 25 years, those with a parity ≥ 1 had lower MMEF during the first trimester and lower PEF during the third trimester [15]. Fourthly, it appears that parity accelerated lung-aging, with an increase of one parity rising the estimated lung-age by 1.2 years [12, 13].…”

“…The discrepancy between reported results in literature may be due to some different obstetric/anthropometric characteristics of the included females (S2 File): different parity means [4±2 [6], 5±3 [12, 13], 6±3 (this study)], different age ranges [21–28 [16], 18–92 [11], 19–90 [12, 13], 40–74 (this study), 45–90 [6], 60–96 [7]], different applied cutoff for parities [1 [11, 15], 3 [6], 4 [7], 6 (this study)], different groups of parities [n = 2 [6, 7, 11, 15], n = 3 [6], n = 4 [15], n = 5 [14, 16]].…”

“…To the best of the authors’ knowledge, few studies, published between 1999 and 2018, have raised the impact of parity on healthy females’ LFD [USA (n = 1 [ 11]), Tunisia (n = 3 [6, 7, 12]), Nigeria (n = 2 [14, 16]), Brazil (n = 1) [15]] with contradictory results. On the one hand, some studies concluded that high parity was associated with positive effects on LFD of American [ eg , larger forced expiratory volume in 1 s (FEV 1 ) and FVC [11]] or of Nigerian [ eg , increases in FEV 1 and FVC [14], even across all females positions [16]] In the other hand, some other studies concluded that high parity was associated with negative effects on LFD of Tunisian [ eg , reduction in peak flow rate [7], a tendency towards a proximal obstructive ventilatory defect (OVD) [6] and acceleration of lung-aging [12, 13]], or of Brazilian aged < 25 years [ eg , lower maximal mid-expiratory flow (MMEF) and peak expiratory flow (PEF) [15]]. Moreover, a North-African study concluded that compared to aging by one year, the parity increase of one unit, caused a greater LFD’ decline [ eg , FEV 1 declines were 23 and 33 mL, respectively, per year of age and when parity increases by one unit [6]].…”

Analysis of Pulmonary Function and Serum Progesterone Level during Pregnancy: A Cross-sectional Study

“…4 An upward movement of the diaphragm in the later stages of pregnancy is an indication of the pressure developed by the uterus on the abdomen, mitigating negative intrapleural pressure and hyperventilation with a decrease in the partial pressure of carbon dioxide. 5,6 Transverse diameter of the chest increases due to the expanded subcostal angle that resists the effect of expanding the uterus and the upward movement of diaphragm to provide change in the pulmonary function as required for the pregnancy. 7 In the Western part of the globe, parity and smoking are associated with the lung function of pregnant women, which is evaluated by a spirometer.…”