Stenius-Aarniala B, Piirilä P, Teramo K
Department of Pulmonary Medicine, Helsinki University Central Hospital, Finland.
Thorax. 1988 Jan;43(1):12-8. doi: 10.1136/thx.43.1.12.
A study was designed to investigate whether asthma, when carefully managed, is associated with an increased risk of complications in connection with pregnancy. One hundred and eighty one asthmatic women were monitored during 198 pregnancies. Antiasthmatic treatment consisted of inhaled beta 2 adrenergic drugs, beclomethasone, sodium cromoglycate, oral theophylline, and systemic corticosteroids as needed. Postpartum information on asthmatic symptoms and infant feeding was collected by means of a questionnaire. A control group of 198 non-asthmatic pregnant women was matched for age and parity. Atopic women had less severe asthma than non-atopic women. During pregnancy 40% of the patients were managed with the same antiasthmatic medication as before pregnancy; 18% needed less and 42% more medication. Pre-eclampsia occurred more often in asthmatic than control subjects, especially in patients with severe asthma. Hypoglycaemia occurred more often in infants of mothers with severe asthma than in infants of mothers with less severe disease. Theophylline medication at term did not influence labour or delivery. Asthma caused no emergencies during labour. Among the asthmatic subjects 28% of babies were delivered by caesarean section compared with 17% in the control group. There was no difference between asthmatic and control subjects with regard to length of gestation, birth weight, incidence of perinatal deaths, low Apgar scores, neonatal respiratory difficulties, hyperbilirubinaemia, or malformations. It is concluded that severe asthma or systemic corticosteroid treatment (or both) during pregnancy seems to increase the incidence of mild pre-eclampsia in the mother and hypoglycaemia in the infant. The findings suggest that careful supervision of asthma during pregnancy and labour by obstetricians and chest physicians working in close collaboration should prevent most of the serious obstetric and neonatal complications of asthma in pregnancy reported by previous authors.
一项研究旨在调查哮喘在得到精心管理的情况下是否与妊娠相关并发症风险增加有关。在198次妊娠期间对181名哮喘女性进行了监测。抗哮喘治疗包括吸入β2肾上腺素能药物、倍氯米松、色甘酸钠、口服茶碱以及必要时使用全身皮质类固醇。通过问卷调查收集产后哮喘症状和婴儿喂养方面的信息。选取了198名非哮喘孕妇作为对照组，在年龄和胎次上进行匹配。特应性女性的哮喘症状不如非特应性女性严重。在孕期，40%的患者使用与孕前相同的抗哮喘药物治疗；18%的患者所需药物减少，42%的患者所需药物增加。子痫前期在哮喘患者中比对照组更常见，尤其是在重症哮喘患者中。重症哮喘母亲的婴儿发生低血糖的情况比病情较轻母亲的婴儿更常见。足月时使用茶碱药物对分娩过程没有影响。哮喘在分娩过程中未引发紧急情况。在哮喘患者中，28%的婴儿通过剖宫产分娩，而对照组这一比例为17%。在妊娠时长、出生体重、围产期死亡率、阿氏评分低、新生儿呼吸困难、高胆红素血症或畸形方面，哮喘患者与对照组之间没有差异。研究得出结论，孕期严重哮喘或全身皮质类固醇治疗（或两者皆有）似乎会增加母亲发生轻度子痫前期和婴儿发生低血糖的发生率。研究结果表明，产科医生和胸科医生密切合作，在孕期和分娩期间对哮喘进行仔细监测，应能预防先前作者报道的大多数妊娠哮喘严重产科和新生儿并发症。
