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Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study

STUDY QUESTION: Is the chance of childbirth, and risk of infertility, pregnancy loss and need for assisted reproduction different for women with asthma compared to women without asthma? SUMMARY ANSWER: Women with asthma had comparable chances of giving birth compared to the reference population, how...

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Autores principales: Jöud, Anna, Nilsson-Condori, Emma, Schmidt, Lone, Ziebe, Søren, Vassard, Ditte, Mattsson, Kristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712942/
https://www.ncbi.nlm.nih.gov/pubmed/36215654
http://dx.doi.org/10.1093/humrep/deac216
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author Jöud, Anna
Nilsson-Condori, Emma
Schmidt, Lone
Ziebe, Søren
Vassard, Ditte
Mattsson, Kristina
author_facet Jöud, Anna
Nilsson-Condori, Emma
Schmidt, Lone
Ziebe, Søren
Vassard, Ditte
Mattsson, Kristina
author_sort Jöud, Anna
collection PubMed
description STUDY QUESTION: Is the chance of childbirth, and risk of infertility, pregnancy loss and need for assisted reproduction different for women with asthma compared to women without asthma? SUMMARY ANSWER: Women with asthma had comparable chances of giving birth compared to the reference population, however, their risk of both infertility and pregnancy loss, as well their need for medically assisted reproduction, was higher. WHAT IS KNOWN ALREADY: Reproductive dysfunction has been reported among women with asthma, including longer time to pregnancy, increased risk of pregnancy loss and a higher need of medically assisted reproduction, but their risk of clinical infertility is unknown. STUDY DESIGN, SIZE, DURATION: This longitudinal register-based cohort study included all women with a healthcare visit for delivery, infertility, pregnancy loss or induced abortion in the southernmost county in Sweden, over the last 20 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Using the Skåne Healthcare Register, we identified all women aged 15–45 between 1998 and 2019, who received a diagnosis of asthma before their first reproductive outcome (n = 6445). Chance of childbirth and risk of infertility, pregnancy loss and assisted reproduction were compared to a healthcare seeking population of women without any asthma (n = 200 248), using modified Poisson regressions. MAIN RESULTS AND THE ROLE OF CHANCE: The chance of childbirth was not different between women with asthma versus those without, adjusted risk ratio (aRR) = 1.02, 95% CI: 1.01–1.03. The risk of seeking care for infertility was increased, aRR = 1.29, 95% CI: 1.21–1.39, and women with asthma more often needed assisted reproduction aRR = 1.34 95% CI: 1.18–1.52. The risk of suffering a pregnancy loss was higher, aRR = 1.21, 95% CI: 1.15–1.28, and induced abortions were more common, aRR = 1.15, 95% CI: 1.11–1.20, among women with asthma. LIMITATIONS, REASONS FOR CAUTION: The study was an observational study based on healthcare visits and lacked detailed anthropometric data, thus residual confounding cannot be excluded. Only women with a healthcare visit for a reproductive outcome were included, which cannot be translated into pregnancy intention. A misclassification, presumed to be non-differential, may arise from an incorrect or missing diagnosis of asthma or female infertility, biasing the results towards the null. WIDER IMPLICATIONS OF THE FINDINGS: This study points towards reproductive dysfunction associated with asthma, specifically in regards to the ability to maintain a pregnancy and the risk of needing medically assisted reproduction following clinical infertility, but reassuringly the chance of subsequently giving birth was not lower for these women. STUDY FUNDING/COMPETING INTEREST(S): This article is part of the ReproUnion collaborative study, co-financed by EU Interreg ÖKS, Capital Region of Denmark, Region Skåne and Ferring Pharmaceuticals. The authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER: N/A.
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spelling pubmed-97129422022-12-02 Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study Jöud, Anna Nilsson-Condori, Emma Schmidt, Lone Ziebe, Søren Vassard, Ditte Mattsson, Kristina Hum Reprod Original Article STUDY QUESTION: Is the chance of childbirth, and risk of infertility, pregnancy loss and need for assisted reproduction different for women with asthma compared to women without asthma? SUMMARY ANSWER: Women with asthma had comparable chances of giving birth compared to the reference population, however, their risk of both infertility and pregnancy loss, as well their need for medically assisted reproduction, was higher. WHAT IS KNOWN ALREADY: Reproductive dysfunction has been reported among women with asthma, including longer time to pregnancy, increased risk of pregnancy loss and a higher need of medically assisted reproduction, but their risk of clinical infertility is unknown. STUDY DESIGN, SIZE, DURATION: This longitudinal register-based cohort study included all women with a healthcare visit for delivery, infertility, pregnancy loss or induced abortion in the southernmost county in Sweden, over the last 20 years. PARTICIPANTS/MATERIALS, SETTING, METHODS: Using the Skåne Healthcare Register, we identified all women aged 15–45 between 1998 and 2019, who received a diagnosis of asthma before their first reproductive outcome (n = 6445). Chance of childbirth and risk of infertility, pregnancy loss and assisted reproduction were compared to a healthcare seeking population of women without any asthma (n = 200 248), using modified Poisson regressions. MAIN RESULTS AND THE ROLE OF CHANCE: The chance of childbirth was not different between women with asthma versus those without, adjusted risk ratio (aRR) = 1.02, 95% CI: 1.01–1.03. The risk of seeking care for infertility was increased, aRR = 1.29, 95% CI: 1.21–1.39, and women with asthma more often needed assisted reproduction aRR = 1.34 95% CI: 1.18–1.52. The risk of suffering a pregnancy loss was higher, aRR = 1.21, 95% CI: 1.15–1.28, and induced abortions were more common, aRR = 1.15, 95% CI: 1.11–1.20, among women with asthma. LIMITATIONS, REASONS FOR CAUTION: The study was an observational study based on healthcare visits and lacked detailed anthropometric data, thus residual confounding cannot be excluded. Only women with a healthcare visit for a reproductive outcome were included, which cannot be translated into pregnancy intention. A misclassification, presumed to be non-differential, may arise from an incorrect or missing diagnosis of asthma or female infertility, biasing the results towards the null. WIDER IMPLICATIONS OF THE FINDINGS: This study points towards reproductive dysfunction associated with asthma, specifically in regards to the ability to maintain a pregnancy and the risk of needing medically assisted reproduction following clinical infertility, but reassuringly the chance of subsequently giving birth was not lower for these women. STUDY FUNDING/COMPETING INTEREST(S): This article is part of the ReproUnion collaborative study, co-financed by EU Interreg ÖKS, Capital Region of Denmark, Region Skåne and Ferring Pharmaceuticals. The authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER: N/A. Oxford University Press 2022-10-10 /pmc/articles/PMC9712942/ /pubmed/36215654 http://dx.doi.org/10.1093/humrep/deac216 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Jöud, Anna
Nilsson-Condori, Emma
Schmidt, Lone
Ziebe, Søren
Vassard, Ditte
Mattsson, Kristina
Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title_full Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title_fullStr Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title_full_unstemmed Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title_short Infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
title_sort infertility, pregnancy loss and assisted reproduction in women with asthma: a population-based cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9712942/
https://www.ncbi.nlm.nih.gov/pubmed/36215654
http://dx.doi.org/10.1093/humrep/deac216
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