Rey Agnieszka, Chełmińska Marta, Damps-Konstańska Iwona
Department of Pulmonology and Allergology, Medical University of Gdańsk, Gdańsk, Poland.
Eur J Midwifery. 2024 Aug 28;8. doi: 10.18332/ejm/191295. eCollection 2024.
Numerous factors may influence the asthma course during pregnancy, potentially elevating the risk of specific pregnancy complications. This study aimed to evaluate non-allergic factors influencing asthma and to assess perinatal outcomes between asthmatic and non-asthmatic pregnancies in the population of the Pomeranian Voivodeship region of Poland.
The mixed cohort study was performed with 83 pregnant asthmatic patients aged 18-38 years. The control group consisted of 83 patients without asthma diagnosis or symptoms. A specially designed questionnaire was used to evaluate asthma course and perinatal outcomes. An Asthma Control Test (ACT) adapted for pregnancy was performed on enrollment. Asthma severity was assessed according to GINA guidelines.
In 19 cases (22.80%), patients quit their regular treatment after pregnancy was confirmed. Respiratory tract infection occurred in 23 patients (27.71%) and had been statistically significantly more frequent among patients with partially and uncontrolled asthma (χ=8.504, p<0.05). No statistically significant difference was found between infection episodes and perinatal complications. The incidence of cesarean section was significantly higher among patients with asthma (χ=16.37, p<0.01), particularly in patients with severe asthma (χ=7.07, p<0.05) and uncontrolled asthma (χ=6.7, p<0.05). Apgar score was statistically significantly lower in patients with severe asthma (χ=20.37, p<0.05).
Respiratory tract infections and adequate asthma treatment are the most important modifiable factors in preventing perinatal complications associated with asthma.
众多因素可能影响孕期哮喘病程,潜在地增加特定妊娠并发症的风险。本研究旨在评估影响哮喘的非过敏因素,并评估波兰波美拉尼亚省地区哮喘孕妇与非哮喘孕妇的围产期结局。
对83名年龄在18 - 38岁的哮喘孕妇进行了混合队列研究。对照组由83名未诊断出哮喘或无哮喘症状的患者组成。使用专门设计的问卷来评估哮喘病程和围产期结局。入组时进行了适用于妊娠的哮喘控制测试(ACT)。根据全球哮喘防治创议(GINA)指南评估哮喘严重程度。
19例(22.80%)患者在确认怀孕后停止了常规治疗。23例患者(27.71%)发生了呼吸道感染,在部分控制和未控制哮喘的患者中,呼吸道感染在统计学上显著更频繁(χ=8.504,p<0.05)。感染发作与围产期并发症之间未发现统计学上的显著差异。哮喘患者剖宫产的发生率显著更高(χ=16.37,p<0.01),尤其是重度哮喘患者(χ=7.07,p<0.05)和未控制哮喘患者(χ=6.7,p<0.05)。重度哮喘患者的阿氏评分在统计学上显著更低(χ=20.37,p<0.05)。
呼吸道感染和充分的哮喘治疗是预防与哮喘相关的围产期并发症的最重要的可改变因素。