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Journal ArticleDOI

Asthma and Pregnancy

01 Sep 1999-Obstetric Anesthesia Digest-Vol. 19, Iss: 3, pp 172
TL;DR: Asthma is often treated with a combination of short acting inhalers for immediate symptom relief and daily medicines to reduce inflammation.
Abstract: Asthma is one of the most common potentially serious medical problems that can complicate pregnancy. Retrospective data suggest that asthma complicates 1% of pregnancies;8 although it is currently estimated that the prevalence of asthma during pregnancy is 4740.~ Moreover, experiencing and managing asthma during pregnancy is different for the patient and her physician because the effect of both the illness and the treatment on the developing fetus as well as the gravida must be considered. This article reviews the literature regarding asthma and pregnancy in terms of the effects of pregnancy on asthma, the effects of asthma on pregnancy, and the potential effects of asthma medications on pregnancy and the infant. Based on this information, recommendations for the nonpharmacologic and pharmacologic management of chronic and acute asthma during pregnancy are presented.
Citations
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Journal ArticleDOI
TL;DR: The available data and the criteria for the management of asthma in pregnant patients are reviewed and the available data suggest that the general strategy does not differ significantly from management outside pregnancy.

27 citations


Cites background from "Asthma and Pregnancy"

  • ...Unfortunately, the available data on the safety of antiasthmatic drugs have many limits, mainly due to the objective (and ethical) problems in assessing the safety in pregnant women in vivo.(36) The US Food and Drug Administration (FDA) subdivides drugs into five safety categories, based on the available experimental data....

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Journal ArticleDOI
TL;DR: There is a tendency to cease or reduce optimal asthma treatments because pregnant women and/or their clinicians may believe they pose a risk to the fetus, and a lack of clinician awareness of the complications of asthma in pregnancy.
Abstract: Asthma is one of the most common medical conditions in women of childbearing age. There are now data to show that asthma is not a benign condition with respect to maternal and fetal health. Despite this there are several problems encountered in the management of such women. There is a tendency to cease or reduce optimal asthma treatments because pregnant women and/or their clinicians may believe they pose a risk to the fetus. There is also a lack of clinician awareness of the complications of asthma in pregnancy.

17 citations

Journal Article
TL;DR: Asthmatic pregnancies are more likely to result in abortion, premature delivery and low birth weight babies and were also linked with higher rates of maternal UTI, for which a more vigilant monitoring is required.
Abstract: OBJECTIVE To examine the relationship between asthmatic pregnancies and selected maternal and neonatal outcomes in a representative cohort. METHODS A retrospective cohort study was conducted at the Aga Khan University Hospital during the year 2004. A random selection was made of 65 asthmatic and 63 non-asthmatic singleton births. The neonatal outcomes studied were birth weight, premature birth and Apgar scores at 1 and 5 minutes. The maternal outcomes studied were number of hospital admissions, and number of documented UTI during the studied pregnancy and past history of abortions and stillbirths. RESULTS The mean age of asthmatics and nonasthmatics were 28.0 +/- 4.9 years and 27.7 +/- 3.6 years respectively. The average parity among asthmatic women was 2.97 while that in controls was 2.57 (p < 0.137). Neonates born to asthmatic mothers had shorter mean gestational age with increased risk of premature birth and lower Apgar scores. Asthmatic mothers had a greater risk of abortions and low birth weight babies. They also had higher rates of UTIs and hospital admissions. CONCLUSION Asthmatic pregnancies are more likely to result in abortion, premature delivery and low birth weight babies. The asthmatic pregnancies were also linked with higher rates of maternal UTI. Thcrefore a more vigilant monitoring is required in asthmatic pregnancies.

9 citations

Book ChapterDOI
06 Sep 2011
TL;DR: This chapter will review the association between air pollution and adverse pregnancy outcomes(APO), such as LBW and PTB, and discuss how to decrease these APOs.
Abstract: Air pollution is known to be associated with increased total mortality, including cardiovascular and respiratory mortality. People with chronic disease in adulthood, such as cardiovascular disease, metabolic syndrome and respiratory diseases, are very susceptible with air pollutants (Kwon HJ et al., 2003). However, air pollution adversely impacts not only adults and the elderly but also fetuses and children. In fact, fetuses are the most vulnerable group to air pollution because vulnerability and susceptibility to air pollution are formed at early ages. Low birth weight (LBW), pre-term delivery (PTB), intrauterine growth restriction, and post-neonatal infant mortality are such undesirable outcomes. LBW affects 20 million infants worldwide (UNICEF, 2004). LBW is comprised of two overlapping etiologies: PTB and intrauterine growth retardation (IUGR). In particular, LBW is associated with a higher risk of infant and childhood mortality, coronary heart disease, and other health problems. LBW additionally has a well-established association with earlyonset insulin resistance and a later risk of adulthood diseases, including all aspects of the metabolic syndrome. PTB remains the leading cause of perinatal mortality and occurs in approximately 4-10% of pregnancies (Reagan and Salsberry 2005). Known risk factors for PTB include lower social class, less education, single marital status, low income, younger maternal age, low body weight, ethnicity, smoking, and poor housing, along with medical factors such as induction, premature rupture of membranes, infection, multiple pregnancy, intrauterine death, fetal and uterine abnormalities and chorioamnionitis (Bibby and Stewart 2004). LBW and PTB are both significantly associated with infant mortality and an array of infant morbidities that range from pulmonary to neurologic outcomes. These associations form the basis for the “fetal origins” or the “Barker hypothesis” which postulates that “fetal growth retardation consequent to malnutrition has long-term structural and physiologic impacts that predispose an individual to chronic diseases in adulthood” (Barker, 2007). Is there the association between air pollution and adverse pregnancy outcomes, such LBW, and PTB? In this chapter, we will review the association between air pollution and adverse pregnancy outcomes(APO), such as LBW and PTB. We also will estimate the disease burden of LBW and PTB caused by air pollution, and discuss how to decrease these APOs.

4 citations

01 Dec 2009
TL;DR: Se puede afirmar that the contaminación ambiental, se manifiesta en forma cíclica durante el año, afectando the ERA en the mujer embarazada, existiendo una correlación significativa entre las PM10, SO2 y asma no específica y the DV y the estados gripales.
Abstract: La contaminación ambiental es uno de los factores que contribuye a exacerbar las enfermedades respiratorias (ERA) y que puede afectar el embarazo. Se tomaron los registros de consulta externa y de urgencias del Hospital de Suba y se tabularon las cinco primeras causas de ERA, correlacionándolas con los promedios mensuales del material particulado PM10, concentración de Gases NO, N02, NOx, SO2, flujo radiante (W), dirección del viento (DV) y temperatura medio ambiente (TPM). En la evaluación estadística, se utilizaron medidas de tendencia central y el índice de correlación de Pearson. Se tabularon 6.310 casos que ingresaron al Hospital, de los cuales, 1.307 correspondieron a mujeres embarazadas (27,9%). Las cinco primeras causas de ERA presentaron una frecuencia de asma no específica (26,1%), amigdalitis (24,4%) gripa (21,8%), faringitis (16%) y asma (11,5%). Las diferencias promedio de las variables mostraron diferencias entre el primer y el segundo semestre, así: W (X=177 vs 155), DV (225,7 vs 199,5), ToC (16,8 vs 15,6) y PM10 (94,23 vs 84,86), y para los gases: NO (10,5 vs 15,2), NO2 (15,9 vs 16,4), NOx (28,5 vs 31,8) y SO2 (2,0 vs 3,2). En su correlación mostró una fuerte asociación entre PM10, SO2 y asma no específica (p<0,007 y 0,0048) y DV y estado gripal (0,048). Se puede afirmar que la contaminación ambiental, se manifiesta en forma cíclica durante el año, afectando la ERA en la mujer embarazada, existiendo una correlación significativa entre las PM10, SO2 y asma no específica y la DV y los estados gripales.

2 citations


Cites background from "Asthma and Pregnancy"

  • ...Entre estas enfermedades, se destaca el asma bronquial (Schatz, 1999), la neumonía (Berkowits & Sala, 1990; Rodríguez & Niederman, 1992), el tromboembolismo pulmonar (TEP) y la trombosis venosa profunda (TVP) (Danilenko-Dixon et al. 2001)....

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  • ...La mayoría de estudios se han centrado enlos efectos de la contaminación del aire sobre la mortalidad y la morbilidad del aparato respiratorio (Schatz, 1999)....

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