Mandal Mita, Halder Indranil, Sarkar Subhankar, Haque Arman, Pal Manidip
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Kalyani, West Bengal, India.
Department of Pulmonary Medicine, College of Medicine and Jawaharlal Nehru Memorial Hospital, Kalyani, West Bengal, India.
Lung India. 2025 Mar 1;42(2):87-90. doi: 10.4103/lungindia.lungindia_413_24. Epub 2025 Feb 27.
Asthma is a common respiratory disease in pregnancy, with approximately 18% of cases worsening. Small airway disease (SAD) with a reported prevalence of up to 70% is now recognised as a principal indicator of poor asthma control. Impulse oscillometry (IOS) is a non-invasive, technically easier, and patient-friendly tool for detecting SAD. We aimed to assess the prevalence of SAD in pregnant women with asthma and the acceptance of the IOS across different trimesters of pregnancy.
This cross-sectional study was conducted among pregnant women aged ≥18 years with clinically diagnosed asthma. All patients underwent IOS following manufacturer and European Respiratory Society guidelines. A questionnaire was used to assess their satisfaction with the technique.
Out of 78 patients who underwent IOS, SAD was present in 55.1% (95% CI = 43.4 to 66.4%). Post-bronchodilator reversibility was observed in 37.2% of patients. Abnormal total (R5) and larger (R20) airway resistance were found in 79.5% and 64.1% of patients, respectively. Other IOS parameters (Fres, AX, and X5) were abnormal in 58.9%, 30.7%, and 39.7% of patients, respectively. Bivariate and multivariate logistic regression analyses indicated longer duration of asthma (OR = 1.1; 95% CI = 1.05-1.18; P < 0.001) and passive smoking (OR = 4.2; 95% CI = 1.58-11.1; P = 0.004) were significantly associated with SAD. All participants tolerated the IOS well, with a satisfaction score of 4.75 ± 0.72.
The IOS is a helpful tool for the evaluation of SAD, a significant comorbidity in pregnant women with asthma. Factors such as longer disease duration and exposure to passive smoking, akin to risk factors for chronic airflow obstruction, are significantly associated with SAD. Future research should explore SAD's impact on clinical management and overall asthma outcomes.
哮喘是妊娠期常见的呼吸系统疾病，约18%的病例病情会加重。小气道疾病（SAD）的报告患病率高达70%，现已被视为哮喘控制不佳的主要指标。脉冲振荡法（IOS）是一种用于检测SAD的非侵入性、技术操作更简便且对患者友好的工具。我们旨在评估哮喘孕妇中SAD的患病率以及IOS在妊娠不同阶段的接受情况。
本横断面研究在年龄≥18岁且临床诊断为哮喘的孕妇中进行。所有患者均按照制造商和欧洲呼吸学会的指南接受IOS检查。使用问卷评估她们对该技术的满意度。
在接受IOS检查的78例患者中，55.1%（95%置信区间=43.4%至66.4%）存在SAD。37.2%的患者观察到支气管扩张剂后可逆性。分别有79.5%和64.1%的患者发现总气道阻力（R5）和较大气道阻力（R20）异常。其他IOS参数（Fres、AX和X5）分别在58.9%、30.7%和39.7%的患者中异常。二元和多因素逻辑回归分析表明，哮喘病程较长（比值比=1.1；95%置信区间=1.05-1.18；P<0.001）和被动吸烟（比值比=4.2；95%置信区间=1.58-11.1；P=0.004）与SAD显著相关。所有参与者对IOS耐受性良好，满意度评分为4.75±0.72。
IOS是评估SAD的有用工具，SAD是哮喘孕妇的一种重要合并症。疾病持续时间较长和接触被动吸烟等因素，类似于慢性气流阻塞的危险因素，与SAD显著相关。未来的研究应探讨SAD对临床管理和整体哮喘结局的影响。
