Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia. 2 Dept of Allergy, Kaiser Permanente Medical Center, San Diego, CA, USA.
Eur Respir Rev. 2014 Mar 1;23(131):64-8. doi: 10.1183/09059180.00008313.
Asthma commonly occurs in pregnant females, and recent data have outlined the risks of adverse perinatal outcomes among this population. There is an increased risk of low birth weight and small for gestational age, particularly among females with moderate-to-severe asthma and exacerbations during pregnancy. There is also an increased risk of preterm birth, especially with oral steroid use, a small but statistically significant increased risk of congenital malformations, particularly of cleft lip with or without cleft palate, and an increased risk of neonatal hospitalisation and death. Active management may reduce these risks, possibly through reductions in exacerbations. Additional reassuring data have been presented for asthma medication use, which support the benefits outweighing the risks of indicated asthma medication use in pregnancy. Viral infections are an important trigger of asthma exacerbations in pregnancy, and recent data provides possible immunological changes that may explain this. Poor medication adherence despite worsening asthma symptoms in pregnancy is a problem which continues to be demonstrated in the literature. Improving asthma control in pregnancy has the potential to improve not only the mother's health but also that of her child.
哮喘在孕妇中较为常见，最近的数据概述了该人群围产期不良结局的风险。出生体重低和小于胎龄儿的风险增加，尤其是在中度至重度哮喘和怀孕期间哮喘加重的女性中。早产的风险也增加，尤其是在使用口服类固醇时，先天性畸形的风险略有增加但具有统计学意义，尤其是唇裂伴或不伴腭裂，新生儿住院和死亡的风险也增加。积极的管理可能会降低这些风险，可能是通过减少恶化。此外，还提出了关于哮喘药物使用的令人安心的数据，这些数据支持在怀孕期间使用有指征的哮喘药物利大于弊。病毒感染是妊娠中哮喘加重的一个重要诱因，最近的数据提供了可能的免疫变化，可以解释这一点。尽管在怀孕期间哮喘症状恶化，但药物依从性差仍然是文献中不断证明的问题。改善妊娠期间的哮喘控制不仅有可能改善母亲的健康，还有可能改善其孩子的健康。
