Cargando…

Asthma Management in Pregnancy

BACKGROUND: Asthma is common during pregnancy, however research is limited regarding the extent and timing of changes in asthma management associated with pregnancy. OBJECTIVE: To determine the prevalence of asthma during pregnancy and identify changes in treatment and asthma exacerbation rates asso...

Descripción completa

Detalles Bibliográficos
Autores principales: Charlton, Rachel A., Hutchison, Annie, Davis, Kourtney J., de Vries, Corinne S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617219/
https://www.ncbi.nlm.nih.gov/pubmed/23593182
http://dx.doi.org/10.1371/journal.pone.0060247
_version_ 1782265241044779008
author Charlton, Rachel A.
Hutchison, Annie
Davis, Kourtney J.
de Vries, Corinne S.
author_facet Charlton, Rachel A.
Hutchison, Annie
Davis, Kourtney J.
de Vries, Corinne S.
author_sort Charlton, Rachel A.
collection PubMed
description BACKGROUND: Asthma is common during pregnancy, however research is limited regarding the extent and timing of changes in asthma management associated with pregnancy. OBJECTIVE: To determine the prevalence of asthma during pregnancy and identify changes in treatment and asthma exacerbation rates associated with pregnancy, while controlling for seasonal influences. METHODS: Pregnant women with asthma were identified from the UK General Practice Research Database between 2000 and 2008. For each woman asthma medication prescribed during the study period was identified; for each product combination the British Thoracic Society medication-defined asthma treatment step was identified. Asthma exacerbations were identified during pregnancy and in the corresponding 12 months prior. Analyses of changes in asthma treatment and exacerbation rates during pregnancy relative to the corresponding period 12 months prior, to control for seasonality, were stratified by trimester and asthma treatment intensity level. RESULTS: The prevalence of treated asthma in pregnancies resulting in a delivery was 8.3%. From 14,141 pregnancies, in 12,828 women with asthma, 68.4% received prescriptions for a short-acting β(2)-agonist and 41.2% for inhaled corticosteroids; 76.5% were managed with asthma treatment Step 1 or 2. Poor persistence to inhaled corticosteroids, defined as a gap of up to 60 days between prescriptions, was common. In 45.0% of pregnancies, an increase in average treatment step was observed whereas in 25.6% the treatment step decreased. Treatment intensity remained the same in 29.5% of pregnancies. Exacerbations occurred in 4.8% of pregnancies compared to 5.9% in the same season the year before (p<0.001). CONCLUSION: Exacerbation rates during pregnancy were slightly lower than in the year before. However, treatment patterns and exacerbation rates in this study suggest asthma control during pregnancy is variable, and women may require close monitoring especially in those with evidence of poor control before pregnancy.
format Online
Article
Text
id pubmed-3617219
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-36172192013-04-16 Asthma Management in Pregnancy Charlton, Rachel A. Hutchison, Annie Davis, Kourtney J. de Vries, Corinne S. PLoS One Research Article BACKGROUND: Asthma is common during pregnancy, however research is limited regarding the extent and timing of changes in asthma management associated with pregnancy. OBJECTIVE: To determine the prevalence of asthma during pregnancy and identify changes in treatment and asthma exacerbation rates associated with pregnancy, while controlling for seasonal influences. METHODS: Pregnant women with asthma were identified from the UK General Practice Research Database between 2000 and 2008. For each woman asthma medication prescribed during the study period was identified; for each product combination the British Thoracic Society medication-defined asthma treatment step was identified. Asthma exacerbations were identified during pregnancy and in the corresponding 12 months prior. Analyses of changes in asthma treatment and exacerbation rates during pregnancy relative to the corresponding period 12 months prior, to control for seasonality, were stratified by trimester and asthma treatment intensity level. RESULTS: The prevalence of treated asthma in pregnancies resulting in a delivery was 8.3%. From 14,141 pregnancies, in 12,828 women with asthma, 68.4% received prescriptions for a short-acting β(2)-agonist and 41.2% for inhaled corticosteroids; 76.5% were managed with asthma treatment Step 1 or 2. Poor persistence to inhaled corticosteroids, defined as a gap of up to 60 days between prescriptions, was common. In 45.0% of pregnancies, an increase in average treatment step was observed whereas in 25.6% the treatment step decreased. Treatment intensity remained the same in 29.5% of pregnancies. Exacerbations occurred in 4.8% of pregnancies compared to 5.9% in the same season the year before (p<0.001). CONCLUSION: Exacerbation rates during pregnancy were slightly lower than in the year before. However, treatment patterns and exacerbation rates in this study suggest asthma control during pregnancy is variable, and women may require close monitoring especially in those with evidence of poor control before pregnancy. Public Library of Science 2013-04-04 /pmc/articles/PMC3617219/ /pubmed/23593182 http://dx.doi.org/10.1371/journal.pone.0060247 Text en © 2013 Charlton et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Charlton, Rachel A.
Hutchison, Annie
Davis, Kourtney J.
de Vries, Corinne S.
Asthma Management in Pregnancy
title Asthma Management in Pregnancy
title_full Asthma Management in Pregnancy
title_fullStr Asthma Management in Pregnancy
title_full_unstemmed Asthma Management in Pregnancy
title_short Asthma Management in Pregnancy
title_sort asthma management in pregnancy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617219/
https://www.ncbi.nlm.nih.gov/pubmed/23593182
http://dx.doi.org/10.1371/journal.pone.0060247
work_keys_str_mv AT charltonrachela asthmamanagementinpregnancy
AT hutchisonannie asthmamanagementinpregnancy
AT daviskourtneyj asthmamanagementinpregnancy
AT devriescorinnes asthmamanagementinpregnancy