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21 世纪 20 年代的哮喘与妊娠:仍需关注。

Asthma and pregnancy in the 2020 decade: still a matter of concern.

机构信息

Pulmonology Department, Egas Moniz Hospital, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.

Allergy Center, CUF Descobertas Hospital and CUF Tejo Hospital, Lisbon, Portugal.

出版信息

J Matern Fetal Neonatal Med. 2022 Dec;35(25):6498-6504. doi: 10.1080/14767058.2021.1916462. Epub 2021 Apr 29.

DOI:10.1080/14767058.2021.1916462
PMID:33926358
Abstract

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.

摘要

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。

相似文献

1
Asthma and pregnancy in the 2020 decade: still a matter of concern.21 世纪 20 年代的哮喘与妊娠:仍需关注。
J Matern Fetal Neonatal Med. 2022 Dec;35(25):6498-6504. doi: 10.1080/14767058.2021.1916462. Epub 2021 Apr 29.
2
Fractional exhaled nitric oxide measurements in rhinitis and asthma in children.儿童变应性鼻炎和哮喘的呼出气一氧化氮测定。
Int J Immunopathol Pharmacol. 2011 Oct;24(4 Suppl):29-32. doi: 10.1177/03946320110240s407.
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Exhaled nitric oxide levels to guide treatment for children with asthma.呼出一氧化氮水平用于指导儿童哮喘治疗。
Cochrane Database Syst Rev. 2016 Nov 9;11(11):CD011439. doi: 10.1002/14651858.CD011439.pub2.
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MODERN APPROACHES TO FRACTIONAL EXHALED NITRIC OXIDE AS A USEFUL BIOMARKER FOR ALLERGIC ASTHMA PHENOTYPING AND MANAGEMENT.呼出气一氧化氮分数作为过敏性哮喘表型分析和管理的有用生物标志物的现代研究方法
Georgian Med News. 2017 Dec(273):51-55.
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Fractioned exhaled nitric oxide (FE(NO)) is not a sufficiently reliable test for monitoring asthma in pregnancy.呼出气一氧化氮分数(FE(NO))不是监测妊娠哮喘的一种足够可靠的检测方法。
Nitric Oxide. 2013 Sep 1;33:56-63. doi: 10.1016/j.niox.2013.06.001. Epub 2013 Jun 10.
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Cost-effectiveness and Budget Impact of Routine Use of Fractional Exhaled Nitric Oxide Monitoring for the Management of Adult Asthma Patients in Spain.西班牙对成年哮喘患者进行常规呼出一氧化氮监测管理的成本效益和预算影响
J Investig Allergol Clin Immunol. 2017;27(2):89-97. doi: 10.18176/jiaci.0103. Epub 2016 Aug 26.
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Comparison of orally exhaled nitric oxide in allergic versus nonallergic rhinitis.比较变应性与非变应性鼻炎患者呼出气一氧化氮。
Am J Rhinol Allergy. 2012 Mar-Apr;26(2):e50-4. doi: 10.2500/ajra.2012.26.3717.
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[The long-term variability of FeNO in pregnant asthmatic women with controlled asthma].[哮喘控制良好的妊娠哮喘女性呼出气一氧化氮的长期变异性]
Pneumonol Alergol Pol. 2013;81(2):114-20.
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The use of fractional exhaled nitric oxide is valuable in select asthmatic patients.呼出一氧化氮分数测定在特定哮喘患者中具有重要价值。
Curr Opin Otolaryngol Head Neck Surg. 2016 Jun;24(3):256-60. doi: 10.1097/MOO.0000000000000247.
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A Review of the Utility and Cost Effectiveness of Monitoring Fractional Exhaled Nitric Oxide (FeNO) in Asthma Management.哮喘管理中监测呼出一氧化氮分数(FeNO)的效用及成本效益综述
Manag Care. 2018 Jul;27(7):34-41.

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J Physiol. 2025 Mar;603(5):1241-1261. doi: 10.1113/JP287583. Epub 2025 Feb 6.
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Complex interplays: Asthma management and maternal‑fetal outcomes in pregnancy (Review).复杂的相互作用:孕期哮喘管理与母胎结局(综述)
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Arch Gynecol Obstet. 2024 Sep;310(3):1433-1440. doi: 10.1007/s00404-023-07347-4. Epub 2024 Jan 26.
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Asthma and pregnancy.哮喘与妊娠
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New onset asthma during pregnancy: two case reports.妊娠期新发哮喘:两例病例报告。
F1000Res. 2023 Mar 1;10:1120. doi: 10.12688/f1000research.73188.2. eCollection 2021.