Faculty of Medicine and Allied Sciences, Department of Physiology, Rajarata University of Sri Lanka, Mihintale, Sri Lanka.
Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Mihintale, Sri Lanka.
PLoS One. 2022 Jul 14;17(7):e0269888. doi: 10.1371/journal.pone.0269888. eCollection 2022.
To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography.
We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters.
We recruited 3374 pregnant women aged 15-48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89-0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women.
This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.
描述农村地区孕妇的哮喘流行病学及妊娠结局。
我们在斯里兰卡的阿努拉达普拉区进行了一项前瞻性队列研究，纳入了所有在母婴保健项目中登记的符合条件的孕妇。在妊娠的第 1 和第 2 个三个月，通过访谈员管理的问卷进行症状分析和临床评估。
我们招募了 3374 名年龄在 15-48 岁之间的孕妇。自我报告的医生诊断的哮喘患病率为 6.6%（n = 223），仅有 41.7%（n = 93）的哮喘患者接受了定期的医学随访。在妊娠前（67.0%）、第 1 个（46.4%）和第 2 个（47.7%）三个月（p<0.01），哮喘患者的喘息患病率降低。在妊娠前的 3 个月内没有喘息的 73 名哮喘女性中，分别有 6 名（8.2%）和 12 名（16.4%）在第 1 和第 2 个三个月报告了新发作的喘息。在私营部门因哮喘寻求医疗服务的孕妇，在第 1 个三个月发生新发作喘息的可能性较低（p = 0.03；未调整的 OR = 0.94；95%CI 0.89-0.99）。在妊娠的第 1 和第 2 个三个月，有 34 名（33.3%）孕妇因喘息加重而至少有一次住院治疗。哮喘孕妇的低出生体重（16.0%）患病率较高。
本研究报告了农村地区女性哮喘的高患病率和与哮喘相关的妊娠结局，表明需要进行有针对性的管理。
