Pregnancy Related Treatment Disparities of Acute Asthma Exacerbations in the Emergency Department

Respir Med. 2011 Oct;105(10):1434-40. doi: 10.1016/j.rmed.2011.05.015. Epub 2011 Jun 22.

Abstract

Objective: Asthma is one of the most common medical conditions complicating pregnancy. Despite the presence of published guidelines outlining the care of the pregnant patient with asthma, disparities in the treatment of acute asthma exacerbations in the emergency department related to pregnancy status are known to exist. We sought to determine if pregnancy status affected the treatment of women presenting to a tertiary emergency department for care of acute asthma exacerbations.

Methods: We retrospectively compared the emergency department treatment of acute asthma exacerbations in 123 pregnant women to 123 non-pregnant controls. Asthma exacerbations were classified by severity according to pre-determined criteria.

Results: In the emergency department (ED), pregnant women were significantly less likely to be treated with systemic corticosteroids than non-pregnant controls (50.8% versus 72.4%, p = 0.001). Similarly, 41% of pregnant women received prescriptions for prednisone at the time of discharge from the ED compared to 69.2% of non-pregnant women (p < 0.001).

Conclusions: In this population of asthmatics presenting to a tertiary emergency department with acute asthma exacerbations, pregnant women were less likely to receive appropriate therapy with systemic corticosteroids.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • Drug Administration Schedule
  • Emergency Service, Hospital / standards
  • Emergency Service, Hospital / statistics & numerical data*
  • Emergency Treatment / statistics & numerical data*
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Medical Records
  • Middle Aged
  • Practice Guidelines as Topic
  • Prednisolone / administration & dosage*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / epidemiology
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Prednisolone