Stenius-Aarniala B S, Hedman J, Teramo K A
Department of Medicine, Helsinki University Central Hospital, Finland.
Thorax. 1996 Apr;51(4):411-4. doi: 10.1136/thx.51.4.411.
Acute asthma during pregnancy is potentially dangerous to the fetus. The aim of this study was to investigate the effect of an acute attack of asthma during pregnancy on the course of pregnancy or delivery, or the health of the newborn infant, and to identify undertreatment as a possible cause of the exacerbations.
Five hundred and four pregnant asthmatic subjects were prospectively followed and treated. The data on 47 patients with an attack of asthma during pregnancy were compared with those of 457 asthmatics with no recorded acute exacerbation and with 237 healthy parturients.
Of 504 asthmatics, 177 patients were not initially treated with inhaled corticosteroids. Of these, 17% had an acute attack compared with only 4% of the 257 patients who had been on inhaled anti-inflammatory treatment from the start of pregnancy. There were no differences between the groups as to length of gestation, length of the third stage of labour, or amount of haemorrhage after delivery. No differences were observed between pregnancies with and without an exacerbation with regard to relative birth weight, incidence of malformations, hypoglycaemia, or need for phototherapy for jaundice during the neonatal period.
Patients with inadequate inhaled anti-inflammatory treatment during pregnancy run a higher risk of suffering an acute attack of asthma than those treated with an anti-inflammatory agent. However, if the acute attack of asthma is relatively mild and promptly treated, it does not have a serious effect on the pregnancy, delivery, or the health of the newborn infant.
孕期急性哮喘对胎儿有潜在危险。本研究的目的是调查孕期哮喘急性发作对妊娠过程、分娩或新生儿健康的影响，并确定治疗不足是否为病情加重的可能原因。
对504名患有哮喘的孕妇进行前瞻性随访和治疗。将47名孕期哮喘发作患者的数据与457名无急性加重记录的哮喘患者以及237名健康产妇的数据进行比较。
在504名哮喘患者中，177名患者最初未接受吸入性糖皮质激素治疗。其中，17%的患者发生了急性发作，而从妊娠开始就接受吸入性抗炎治疗的257名患者中只有4%发作。各组在妊娠时长、第三产程时长或产后出血量方面没有差异。在相对出生体重、畸形发生率、低血糖或新生儿期黄疸光疗需求方面，发作组与未发作组的妊娠情况没有差异。
孕期吸入性抗炎治疗不足的患者比接受抗炎药物治疗的患者患哮喘急性发作的风险更高。然而，如果哮喘急性发作相对较轻且得到及时治疗，它对妊娠、分娩或新生儿健康不会产生严重影响。
