Observational study of mental health in asthmatic women during the prenatal and postnatal periods

Whalen, Olivia M.; Campbell, Linda E.; Murphy, Vanessa E.; Lane, Alison E.; Gibson, Peter G.; Mattes, Joërg; Collison, Adam; Mallise, Carly A.; Woolard, Alix; Karayanidis, Frini

doi:10.1080/02770903.2019.1621888

Cited by 12 publications

(4 citation statements)

References 68 publications

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“…The prevalence of depression and other mental illnesses is common among pregnant women with asthma [33,69]. Adults with asthma and depression/anxiety have higher rates of other risk factors for asthma exacerbations, such as smoking, obesity and increasing asthma severity, compared to adults with asthma without depression/anxiety [70].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for asthma exacerbations during pregnancy: a systematic review and meta-analysis

et al. 2022

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BackgroundConflicting literature exists regarding the risk factors for exacerbations among pregnant women with asthma. This systematic review and meta-analysis aimed to determine risk factors for asthma exacerbations during pregnancy.MethodsElectronic databases were searched for the following terms: (asthma or wheeze) and (pregnan* or perinat* or obstet*) and (exacerb* or flare up or morbidit* or attack*).All studies published between 2000 and 24 August 2021 were considered for inclusion if they reported at least one potential risk factor of asthma exacerbations in pregnant women with asthma. Of the 3337 references considered, 35 publications involving 429 583 pregnant women with asthma were included. Meta-analyses were conducted to determine mean difference in risk factor between exacerbation groups, or the relative risks of exacerbation with certain risk factors. Good study quality was found through the Newcastle-Ottawa Scale (median score 8, interquartile range 7–9).ResultsIncreased maternal age (mean difference 0.62, 95% CI 0.11–1.13), obesity (relative risk 1.25, 95% CI 1.15–1.37), smoking (relative risk 1.35, 95% CI 1.04–1.75), black ethnicity (relative risk 1.62, 95% CI 1.52–1.73), multiparity (relative risk 1.31, 95% CI 1.01–1.68), depression/anxiety (relative risk 1.42, 95% CI 1.27–1.59), moderate–severe asthma (relative risk 3.44, 95% CI 2.03–5.83, versus mild) and severe asthma (relative risk 2.70, 95% CI 1.85–3.95, versus mild–moderate) were associated with an increased risk of asthma exacerbations during pregnancy.ConclusionsFuture interventions aimed at reducing exacerbations in pregnancy could address the modifiable factors, such as smoking and depression/anxiety, and introduce more regular monitoring for those with nonmodifiable risk factors such as obesity and more severe asthma.

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Section: Discussionmentioning

confidence: 99%

Risk factors for asthma exacerbations during pregnancy: a systematic review and meta-analysis

et al. 2022

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“…Women with depression or anxiety show an increased risk of asthma or wheezing in offspring [97][98][99][100][101]. Moreover, prenatal and postnatal psychopathology concerns are often reported by pregnant women with asthma, and their subjective perception on their asthma control may be more closely associated to psychopathology than objective asthma markers [102]. Psychological disorders are a treatable trait in pregnant asthma patients.…”

Section: Psychological Conditionsmentioning

confidence: 99%

Treatable Traits in Pregnant Women with Asthma

Ramlal,

Van der Meer,

Bendien

2024

Respiration

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Background: Asthma is the most common chronic respiratory disease in pregnancy, affecting approximately 8–10% of pregnant women. Uncontrolled asthma is associated with adverse perinatal outcomes, including low birth weight, preterm birth, and maternal complications such as pre-eclampsia. Summary: A current approach to the management of chronic airway diseases is based on targeting treatable traits. The aim of this review was to define treatable traits in pregnant women with asthma based on recent literature and to determine personalized treatment options according to these traits. Traits addressed in this review that may improve asthma control and pregnancy outcomes are fractional exhaled nitric oxide-based asthma monitoring and treatment, medication adherence and inhalation technique, impaired lung function, smoking cessation and comorbidity including psychological conditions (depression and anxiety), obesity, rhinitis, gastroesophageal reflux disease, chronic rhinosinusitis with or without nasal polyps, and sleep apnea. Key Messages: All the treatable traits discussed have the potential to improve asthma control and pregnancy outcomes in pregnant women with asthma. Further research is needed to determine which management approaches are best to improve asthma control during pregnancy, to identify other relevant treatable traits, and to determine whether the treatable trait approach is feasible and beneficial in pregnant women with asthma.

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“…Anxiety and depression affect 10–25% of pregnant women [ 67 ]. An observational study including 120 pregnant women with asthma found that 20% had a current mental health diagnosis, 14% were receiving mental health care and 47% had self-reported having received mental health care in the past [ 68 ]. During the coronavirus disease 2019 pandemic, the prevalence of anxiety and depression compared to pre-pandemic pregnancy cohorts was shown to be higher, with 37% having symptoms of depression and 57% having symptoms of anxiety [ 67 ].…”

Section: Treatable Traits Of Asthma During Pregnancymentioning

confidence: 99%

Treatable traits in asthma during pregnancy: a call for a shift towards a precision-based management approach

Joshi,

Gibson,

McDonald

et al. 2023

Eur Respir Rev

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Asthma is the most common chronic medical condition in pregnancy. Asthma exacerbations in pregnancy are unpredictable, and are associated with adverse maternal and fetal perinatal outcomes such as preterm birth and low birthweight. Goals of asthma management in pregnancy are to establish effective asthma control and prevent exacerbations. Optimising the management of asthma in pregnancy is an important goal of practice and future research.Treatable traits is a precision medicine paradigm proposed for the management of airways diseases, which holistically addresses the complexity and heterogeneity of airways disease. It is an individualised treatment approach that aims to improve outcomes. This makes treatable traits well suited for pregnant women with asthma, who have a high prevalence of obesity, mental health conditions, poor symptom perception and suboptimal asthma management skills including low treatment adherence. These traits are measurable and treatable. In this review, we explore current knowledge on the burden of asthma, maternal and perinatal consequences of asthma during pregnancy, the treatable traits paradigm, the prevalence of treatable traits in pregnant women with asthma, and consider how the treatable traits paradigm can be integrated into the management of asthma in pregnancy.

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Observational study of mental health in asthmatic women during the prenatal and postnatal periods

Cited by 12 publications

References 68 publications

Risk factors for asthma exacerbations during pregnancy: a systematic review and meta-analysis

Risk factors for asthma exacerbations during pregnancy: a systematic review and meta-analysis

Treatable Traits in Pregnant Women with Asthma

Treatable traits in asthma during pregnancy: a call for a shift towards a precision-based management approach

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