Gade Elisabeth J, Tidemandsen Casper, Hansen Anne V, Ulrik Charlotte S, Backer Vibeke
Dept of Obstetrics and Gynecology, Roskilde Hospital, Copenhagen, Denmark.
Dept of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Copenhagen, Denmark.
Breathe (Sheff). 2022 Jun;18(2):220013. doi: 10.1183/20734735.0013-2022. Epub 2022 Aug 9.
Asthma and infertility are the most common disorders among women of reproductive age. Time to pregnancy is prolonged in women with asthma, and importantly, age seems to be a more important risk factor regarding fertility in women with asthma compared to women without asthma. Some data have shown a higher frequency of miscarriages in women with asthma, although the data are conflicting on this issue as studies have observed no association between asthma and pregnancy loss. Furthermore, studies have shown no negative effect of asthma on the total number of offspring. Pregnancy may, thus, have a significant impact on women with asthma, as well as on their offspring. The age of the women has an important impact on ability to conceive, but also for the pregnancy itself, with higher risk of uncontrolled asthma as well as asthma exacerbations with increasing age. Well-controlled asthma decreases the risk of maternal and fetal complications, while poorly controlled and undertreated asthma is associated with a range of risks for both mother and fetus. Asthma treatment should follow the general guidelines for asthma therapy, irrespective of pregnancy status, including treatment with inhaled corticosteroids, β-agonists and muscarinic antagonists. Targeted treatment with biologics for severe asthma seems to be without important adverse effects. The use of systemic corticosteroids may be associated with adverse events during the first trimester; however, an exacerbation with the associated risk of hypoxaemia is worse for the fetus. Best possible asthma control may be achieved using repeated measurements of fractional exhaled nitric oxide ( ), as the use of compared with symptoms registration only has been shown to reduce exacerbation rate. In conclusion, women with asthma should be encouraged to conceive at an early age, might experience miscarriages, but the number of offspring are the same as in women without asthma. Well treated asthma is important for the well-being of both the mother and the unborn fetus.
哮喘和不孕症是育龄女性中最常见的疾病。哮喘女性的受孕时间会延长，重要的是，与无哮喘女性相比，年龄似乎是哮喘女性生育方面更重要的风险因素。一些数据显示哮喘女性流产的发生率较高，尽管在这个问题上数据存在矛盾，因为一些研究未观察到哮喘与妊娠丢失之间的关联。此外，研究表明哮喘对后代总数没有负面影响。因此，妊娠可能会对哮喘女性及其后代产生重大影响。女性的年龄对受孕能力有重要影响，对妊娠本身也有影响，随着年龄增长，哮喘控制不佳以及哮喘发作的风险更高。良好控制的哮喘可降低母婴并发症的风险，而控制不佳和治疗不足的哮喘与母亲和胎儿的一系列风险相关。哮喘治疗应遵循哮喘治疗的一般指南，无论妊娠状态如何，包括使用吸入性糖皮质激素、β受体激动剂和毒蕈碱拮抗剂进行治疗。针对重度哮喘使用生物制剂进行靶向治疗似乎没有重要的不良反应。在孕早期使用全身性糖皮质激素可能与不良事件相关；然而，伴有低氧血症相关风险的哮喘发作对胎儿的影响更严重。通过重复测量呼出一氧化氮分数（ ）可能实现最佳的哮喘控制，因为与仅根据症状记录相比，使用 已被证明可降低发作率。总之，应鼓励哮喘女性尽早受孕，她们可能会经历流产，但后代数量与无哮喘女性相同。良好治疗哮喘对母亲和未出生胎儿的健康都很重要。
