Use of the Control of Allergic Rhinitis and Asthma Test and pulmonary function tests to assess asthma control in pregnancy

Amaral, Luís; Martins, Carla; Coimbra, Alice

doi:10.1111/ajo.12673

Cited by 10 publications

(4 citation statements)

References 16 publications

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“…However, they did find an improvement of CARAT scores over the course of pregnancy. This improvement might be explained by closer medical supervision and better adherence to medication [117].…”

Section: Comorbiditiesmentioning

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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Section: Comorbiditiesmentioning

confidence: 99%

Treatable Traits in Pregnant Women with Asthma

Ramlal,

Van der Meer,

Bendien

2024

Respiration

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“…19,106 Depending on allergic disease and severity, regular monitoring is recommended during pregnancy. 107 Skin prick tests are not contraindicated in pregnancy, but in vitro tests are preferred over allergy skin tests since systemic reactions have been reported. 108 Intra-dermal tests have a slightly higher risk of systemic reactions and may only be applied if needed to assess specific drug reactions.…”

Section: G Ener Al Cons Ider Ations -Precon Cep Tion Couns Eling and ...mentioning

confidence: 99%

“…Depending on allergic disease and severity, regular monitoring is recommended during pregnancy 107 . Skin prick tests are not contraindicated in pregnancy, but in vitro tests are preferred over allergy skin tests since systemic reactions have been reported 108 .…”

Section: General Considerations—preconception Counseling and Assessmentmentioning

confidence: 99%

Management of allergic diseases in pregnancy

Pfaller

Nederveen-Bendien

Ditisheim

et al. 2021

Allergy

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Allergic diseases like asthma, allergic rhinitis, food allergy, hymenoptera allergy, or atopic dermatitis are highly prevalent in women of childbearing age and may affect up to 30% of this age group. This review focuses on the management of allergic diseases during pregnancy. Furthermore, we discuss the challenges of counseling women with allergic diseases in the reproductive age, including considerations relevant to the ongoing SARS-CoV-2 pandemic. To create the optimal milieu for the unborn child, a multitude of immunological changes occur during pregnancy which may favor type 2 responses and aggravate disease phenotypes. In co-occurrence with suboptimal preconception disease control, this elevated Th2 responses may aggravate allergic disease manifestations during pregnancy and pose a risk for mother and child. Due to limitations in conducting clinical trials in pregnant women, safety data on anti-allergic drugs during pregnancy are limited. The lack of information and concerns among pregnant patients demands counseling on the benefits of anti-allergic drugs and the potential and known risks. This includes information on the risk for mother and child of disease aggravation in the absence of treatment. By doing so, informed decisions and shared decision-making can take place.

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“…CARAT has been used in 19 countries globally including developing countries. 22 CARAT can be used in a range of different aims: (a) screening of patients with rhinitis or asthma in different settings including pharmacies, 42 (b) follow-up consultations together with lung function, 43 (c) patient self-management 44 and (d) identifying patients with uncontrolled asthma at pharmacies. 42 It should increase awareness of the level of disease control and strengthen the partnership between patients and doctors in the management of asthma and rhinitis by helping to define shared treatment goals.…”

Section: Characteristicsmentioning

confidence: 99%