Severity of asthma in pregnancy affects perinatal outcomes

Jana, Narayan; Arora, Nalini; Barik, Sukhamoy

doi:10.1111/j.1471-0528.2011.03258.x

Cited by 2 publications

(1 citation statement)

References 4 publications

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“…We thank Dr Jana and colleagues 1 for their comments on our recent publication 2 . We have conducted meta‐analyses on additional perinatal outcomes, including perinatal mortality, and on mothers with asthma subdivided by severity, exacerbation and oral steroid use.…”

Section: Authors’ Replymentioning

confidence: 99%

Severity of asthma in pregnancy affects perinatal outcomes

Murphy

Namazy

Powell

et al. 2012

BJOG

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Section: Authors’ Replymentioning

confidence: 99%

Severity of asthma in pregnancy affects perinatal outcomes

Murphy

Namazy

Powell

et al. 2012

BJOG

View full text Add to dashboard Cite

Managing asthma in pregnancy

Murphy

2015

Breathe

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Asthma is a common comorbidity during pregnancy and its prevalence is increasing in the community. Exacerbations are a major clinical problem during pregnancy with up to 45% of women needing to seek medical help, resulting in poor outcomes for mothers and their babies, including low birth weight and preterm delivery. The goals of effective asthma management in pregnancy are to maintain the best possible asthma control and prevent exacerbations. This is achieved by aiming to prevent day- and night-time symptoms, and maintain lung function and normal activity. In addition, maintaining fetal oxygenation is an important consideration in pregnancy. Guidelines recommend providing asthma advice and review prior to conception, and managing asthma actively during pregnancy, with regular 4-weekly review, provision of a written action plan, use of preventer medications as indicated for other adults with asthma, and management of comorbid conditions such as rhinitis.Improvements have been made in recent years in emergency department management of asthma in pregnancy, and multidisciplinary approaches are being proposed to optimise both asthma outcomes and perinatal outcomes. One strategy that has demonstrated success in reducing exacerbations in pregnancy is treatment adjustment using a marker of eosinophilic lung inflammation, the exhaled nitric oxide fraction (FeNO). The use of an algorithm that adjusted inhaled corticosteroids (ICS) according to FeNO and added long-acting β-agonists when symptoms remained uncontrolled resulted in fewer exacerbations, more women on ICS but at lower mean doses, and improved infant respiratory health at 12 months of age. Further evidence is needed to determine whether this strategy can also improve perinatal outcomes and be successfully translated into clinical practice.Key pointsAsthma is the most common chronic disease to affect pregnant women.Exacerbations occur in up to 45% of pregnant women with asthma.Asthma should be managed during pregnancy as for other adults.Treatment adjustment using a marker of airway inflammation reduces the exacerbation rate in pregnancy.Educational aimsTo identify the goals of and steps associated with effective asthma management in pregnancy.To understand the maternal and perinatal risks associated with asthma during pregnancy.To describe a management strategy that has been shown to reduce exacerbations in pregnant women with asthma.

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Severity of asthma in pregnancy affects perinatal outcomes

Cited by 2 publications

References 4 publications

Severity of asthma in pregnancy affects perinatal outcomes

Severity of asthma in pregnancy affects perinatal outcomes

Managing asthma in pregnancy

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