Pulmonology Department, Egas Moniz Hospital, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6498-6504. doi: 10.1080/14767058.2021.1916462. Epub 2021 Apr 29.
Asthma is a fairly common health problem for pregnant women and a potentially serious medical condition that may complicate pregnancy. Most complications are related to lack of disease control, which can adversely affect both maternal quality of life and perinatal outcomes. In this article, we review recent literature concerning asthma in pregnancy, describing the course of the disease and associated complications. Furthermore, we review and discuss asthma monitoring and management during pregnancy, labor and post-partum. The course of asthma symptoms during pregnancy is unpredictable but exacerbations are more common during the second trimester. The causes are multifactorial and asthma phenotype may have a role. It has been proposed that combined use of CARAT (Control of Allergic Rhinitis and Asthma Test) and lung function tests can be used to monitor and adjust therapy during pregnancy in patients with asthma. As a complement, an approach that considers airway inflammation assessment using fractional exhaled nitric oxide (FeNO), a noninvasive marker of inflammation, may improve asthma control during pregnancy. It is important to consider a few but relevant differences in asthma management and treatment regarding pregnancy and the peri-partum period to safely achieve optimal management of asthma during all these phases for both mother and offsprings.
哮喘是孕妇较为常见的健康问题,也是一种潜在的严重医疗状况,可能会使妊娠复杂化。大多数并发症与疾病控制不良有关,这可能会对母婴生活质量和围产期结局产生不利影响。本文回顾了有关妊娠哮喘的最新文献,描述了疾病的进程及其相关并发症。此外,我们还回顾和讨论了妊娠、分娩和产后期间的哮喘监测和管理。哮喘症状在妊娠期间的进程是不可预测的,但在妊娠中期更为常见。其病因是多因素的,哮喘表型可能起作用。有人提出,在哮喘患者中,使用 CARAT(过敏性鼻炎和哮喘测试的控制)和肺功能测试联合可以用于监测和调整妊娠期间的治疗。作为补充,考虑使用呼出气一氧化氮分数(FeNO)评估气道炎症的方法,FeNO 是炎症的非侵入性标志物,可能会改善妊娠期间的哮喘控制。考虑到妊娠和围产期期间哮喘管理和治疗的几个但相关的差异,对于母亲和后代来说,在所有这些阶段都安全地实现哮喘的最佳管理是很重要的。