Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes

PLoS One. 2014 Aug 20;9(8):e104755. doi: 10.1371/journal.pone.0104755. eCollection 2014.

Abstract

Background: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes.

Methods: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression.

Results: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4%) pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24) and premature contractions (adj OR 1.52; 95% CI 1.29-1.80). There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34), low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33). The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes.

Conclusion: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Asthma / epidemiology*
  • Comorbidity
  • Female
  • Humans
  • Infant, Newborn
  • Maternal Age
  • Pre-Eclampsia / epidemiology*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome
  • Premature Birth / epidemiology*
  • Prevalence
  • Registries
  • Risk Factors
  • Sweden / epidemiology
  • Young Adult

Grant support

This work was supported by the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and Karolinska Institutet (http://www.forskningsstod.sll.se), the Swedish Research Council (http://www.vr.se/) [grant number 2011–3060] and through the Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework (http://simsam.nu/) [grant number 340-2013-5867], the Swedish Heart-Lung Foundation (http://www.hjart-lungfonden.se/HLF/Om-Hjart-lungfonden/About-HLF/), and the Strategic Research Program in Epidemiology at Karolinska Institutet (http://ki.se/en/research/the-strategic-research-programme-in-epidemiology-sfoepi). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.