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Bronchial Asthma in Pregnancy


Authors: MUDr. Bronislava Novotná, Ph.D.
Authors‘ workplace: Alergologická ambulance, Interní gastroenterologická klinika LF MU a FN Brno
Published in: Prakt Gyn 2007; 11(1): 16-22

Overview

Asthma has been reported to affect to 8.4 percent of pregnant women, making it the most common serious disease complicating pregnancy. The most recent studies suggest that maternal asthma increases the risk of perinatal mortality, preeclampsia, preterm birth and low birth weight infants. This risk is associated particularly with the absence of appropriate treatment of asthma. Variables affecting asthma course during pregnancy and perinatal outcomes are discussed i.e. asthma severity, allergy, smoking, stress, rhinitis (rhinosinusitis), maternal age, asthma education and asthma- self-management skills.

The course of asthma changes in approximately in two-thirds of women during pregnancy and therefore patients should be evaluated at least monthly. The National Asthma Education and Prevention Program (NAEPP), published in January 2005, the Report of the Working Group on Asthma and Pregnancy, which represented the new evidence-based update recommendation for the management. Successful asthma management during pregnancy ensures both asthma control and normal foetal development. Women with proper asthma treatment before pregnancy assure better asthma control before delivery and better perinatal outcomes. It follows the proper asthma treatment all women in childbearing age.

Management of asthma during pregnancy could be carry out by medical team which consists of general practitioner, asthmatologist and gynaecologist with the cooperation of pregnant woman.

Key words:
bronchial asthma, pregnancy, asthma control, change of asthma severity, perinatal outcomes


Sources

1. World Allergy Organisation. Guidelines for Prevetion of Allergy and Allergic Asthma. Allergy Clin Immunol Int 2004; 16: 176-185.

2. Murphy VE, Gibbon PG et al. Asthma during pregnancy: mechanismus and treatment implications. Eur Respir J 2005; 25: 731-750.

3. NAEPP Expert Panel Report. Managing Asthma During Pregnancy: Recommendations for Pharmacolocical Treatment - 2004 Update. J Allergy Clin Immunol 2005; 115: 34-46.

4. Schatz M. Breathing for two: Now we can all breathe a little easier. JACI 2005; 115: 31-33.

5. Liccardi G et al. General strategy for the management of bronchial asthma in pregnancy. Respir Med 2003; 97: 778-789.

6. Novotná B, Pavlík T. Pětileté sledování gravidních astmatiček. Alergie 2006, 8(Suppl 1): 39-45.

7. Špičák V, Kašák V, Pohunek P. Globální strategie péče o astma a jeho prevenci. Praha: Jalna 2003.

8. Luskin AT. Diagnosis and Differential Diagnosis of Bronchial Asthma in Pregnancy. In: Schatz M, Zeiger R, Alaman HN (eds). Asthma and Immunological Diseases in Pregnancy and Early Infancy. New York: Marcel Dekker 1998: 429-499.

9. Blaiss MS. Management of rhinitis and asthma in pregnancy. Ann Allergy Asthma Immunol 2003; 90(suppl 3): 16-22.

10. Wise RA. Pulmonary Function during Pregnancy. In: Schatz M (eds). Asthma and Immunological Diseases in Pregnancy and Early Infancy. New York: Marcel Dekker 1998: 57-72.

11. Triche EW at al. Association of Asthma Diagnosis, Severity, Symptoms, and Treatment With Risk of Preeclampsia. Obstet Gynecol 2004; 104: 585-593.

12. Hofhuis W et al. Adverse health effects of prenatal and postnatal tobacco smoke exposure on children. Arch Dis Child 2003; 88: 1086-1090.

13. Chulada PC et al. Breast-feeding and the prevalence of asthma and and wheeze in children: Analyses from the Third National Health and Nutrition Examination Survey 1988-1994. JACI 2003; 111: 328-336.

14. Salvatore S, Keymolen K, Hauser B et al. Intervention during pregnancy and allergic disease in the offspring. Pediatr Allergy and Immunol 2005; 16: 558-566.

15. Lannero E, WickmanT, PeshagenG et al. Maternal smoking during pregnancy increases the risk of reccurent wheezing during the first years of life (BAMSE). Respir Res 2006; 7: 3.

16. Gluck PA, Gluck JC. Asthma and pregnancy: new concepts, new therapy. AZ-AIR 2005. www.az-air.com

17. Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment – 2004 Update. NAEPP Expert Panel Report. JACI 2005; 115: 34-46.

18. Schatz M et al. Asthma morbidity during pregnancy can be predicted by severity classification. JACI 2003; 112: 283-288.

19. Blaiss MS. Managing asthma during pregnancy, The ways and how of aggressive control. Postgrad Med 2004; 115 (5): 1-11.

20. Boschetto P et al. Women and Asthma. Eur Respiratory Monograph 2003; 25(8): 90-102.

21. Gaga M., Siafakas NM. Special considerations in asthma. Eur Respiratory Monograph 2003; 23(8): 301-311.

22. Bracken MB et al. Asthma Symptoms, Severity, and Drug Therapy: Prospective Study of Effects on 2205 Pregnacies. Obstet Gynecol 2003; 102: 739-752.

23. Cousins L. Fetal oxygenation, assessment of fetal well-being and obstetric management of the pregnant with asthma. JACI 1999; 103: 343-349.

24.Murphy VE at al. Severe asthma exacerbations during pregancy. Obstet Gynecol 2005; 106(5): 1046-1054.

25. Špičák V, Kašák V, Pohunek P. Globální strategie péče o astma a jeho prevenci. Praha: Jalna 2005.

26. Novotná B, Pavlík T. Léčba středně těžkého astmatu v těhotenství. Respirace 2006; 7(2): 30-36.

27. Daves M, Chowienczyk PJ. Pharmacokinetics in pregnancy. Best Pract Res Clin Obstet Gynaecol 2001; 15(6): 819-826.

28. Finnell RH. Teratology: general consideratios and principles. J Allergy Clin Immunol 1999; 103: 337-342.

29. Guy ES et al. Acute asthma in pregnancy. Crit Care Clin 2004; 20(4): 731-745.

30. Position statement. The use of newer asthma and allergy medications during pregnancy. Ann Allergy Asthma Imunol 2000; 84: 475-480.

31. Dykewicz MS. Rhinitis end Sinusitis. JACI 2003; 111: 520-529.

32. Incaudo GA. The diagnosis and treatment of Rhinosinusitis During pregnancy and lactation. In: Schatz M (ed). Asthma and Immunologcal Diseases in Pregnancy and Early Infancy. New York: Marcel Dekker 1998: 279.

33. Ellegard E et al. The Incidence of Pregnancy Rhinitis. Gynecol Obstet Invest 2000; 49: 98-101.

34. Gluck PA, Gluck JC. A review of pregnancy outcomes after exposure to orally or intranasal budesonide. Curr Med Res Opin 2005; 21(7): 1075-1084.

35. Powrie OR. Respiratory disease. Best Pract Res Clin Obstet Gynaecol 2001; 15(6): 913-936.

36. Morreti ME et al. Fetal safety of loratadin use in the first trimestr of pregnancy: A multicenter study. J Allergy Clin Immunol 2003; 111: 479-483.

37. Schatz M. The Efficacy and Safety of Asthma Medication During Pregnancy. Semin Perinatol 2001; 25(3): 145-152.

38. Management of Asthma During Pregnancy. Report of the Working Group on Asthma and Pregnancy. NHLBI 1993 : 49-50.

39. Brinke A et al. Risk factors of frequent exacerbations in diffucult to treat asthma. ERJ 2005; 26: 812-818.

40. Mac Fadden ER jr et al. Asthma. Global Strategy for Asthma Management and Prevention. N Engl J Med 1992; 327: 1928-1937.

41. Williamson C. Gastrointestinal Disease. Best Pract Res Clin Obstet Gynaecol 2001; 15(6): 937-952.

42. Diav-Citrin O et al. The safety of proton pump inhibitor in pregnancy: a multicentre prospective controlled study. Aliment Pharmacol Ther 2005; 21: 269-275.

43. Halken S. Prevetion of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Pediatr Allergy Immunol 2004; (Suppl 16): 9-12.

44. Moffat MF, Cookson WOCM. Gene identification in ashtma and allergy. Int Arch Allergy Immunol 1998; 116: 247-252.

45. World Allergy Organisation. Guidelines for Prevention of Allergy and Allergic Asthma. Allergy Clin Immunol Int 2004; 16: 176-185.

46. Salvatore S, Keymolen K, Hauser B et al. Intervention during pregnancy and allergy disease in the offspring. Pediatr Allergy and Immunol 2005; 16: 558-566.

47. Prescott SL, Tang MLK. The Australasian Society of Clinical Immunology and Allergy position statement: Summary of allergy prevetion in children. MJA 2005; l82: 464-467.

48. Arshad SH. Primary prevention of ashma and allergy. JACI 2005; 116: 3-14.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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