Lim Myoung-Nam, Lee Suk-Hee, Kwon Jae-Woo
Biomedical Research Institute, Kangwon National University Hospital, Chuncheon, Korea.
Department of Statistics, Kangwon National University, Chuncheon, Korea.
Allergy Asthma Immunol Res. 2024 Jul;16(4):434-442. doi: 10.4168/aair.2024.16.4.434.
Pregnancy is a risk factor for asthma exacerbation and may trigger new-onset asthma in nonasthmatics. This study evaluated the epidemiology of newly diagnosed asthma during pregnancy and the associated risk factors among previously nonasthmatic women. Twelve-year medical data from the Korean National Health Insurance claims database (from January 2007 to December 2018) of Korean women who gave birth between January 2012 and December 2015 were collected. Previously nonasthmatic women were defined as those who had not been diagnosed with asthma for at least 4 years before pregnancy. Asthma flare-up was defined as asthma diagnosed three times or more and treated at least once with an oral corticosteroid. A nested case-control study was performed, and then the derived risk factors were applied to whole study population. Among the nonasthmatic women, 7.5% experienced asthma during pregnancy including episodes requiring hospitalization and 18.6% of them visited emergency room. Older age, primiparity, multi-fetal pregnancy, and rhinitis were identified as the risk factors. Among the entire study population, moderate to severe rhinitis was a significant risk factor across all age groups, while primiparity with multi-fetal pregnancy was one for older pregnant women; 22.7% in those ≥ 34 years old experienced asthma flare-ups compared to only 3.5% in the < 34 age group. A substantial portion of pregnant women with no history of asthma experienced an asthma flare-up during pregnancy. Multi-fetal pregnancy as primiparity at a later age and moderate to severe rhinitis are risk factors for the new development of asthma.
怀孕是哮喘加重的一个风险因素,可能会在非哮喘患者中引发新发哮喘。本研究评估了孕期新诊断哮喘的流行病学情况以及既往非哮喘女性中的相关风险因素。收集了2012年1月至2015年12月期间分娩的韩国女性的韩国国民健康保险理赔数据库(2007年1月至2018年12月)中的12年医疗数据。既往非哮喘女性被定义为在怀孕前至少4年未被诊断出患有哮喘的女性。哮喘发作被定义为哮喘被诊断三次或更多次且至少接受过一次口服皮质类固醇治疗。进行了一项巢式病例对照研究,然后将得出的风险因素应用于整个研究人群。在非哮喘女性中,7.5%在孕期经历了哮喘,包括需要住院治疗的发作,其中18.6%的人去过急诊室。年龄较大、初产、多胎妊娠和鼻炎被确定为风险因素。在整个研究人群中,中度至重度鼻炎是所有年龄组的一个重要风险因素,而初产合并多胎妊娠是年龄较大孕妇的一个风险因素;≥34岁的孕妇中有22.7%经历了哮喘发作,而<34岁年龄组中只有3.5%。很大一部分无哮喘病史的孕妇在孕期经历了哮喘发作。多胎妊娠、高龄初产以及中度至重度鼻炎是哮喘新发的风险因素。