RT Journal Article
SR Electronic
T1 Late Breaking Abstract - Management of asthma in pregnancy using fractional exhaled nitric oxide (FENO) to adjust inhaled corticosteroid (ICS) dose did not improve perinatal outcomes: the Breathing for Life Trial (BLT)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 138
DO 10.1183/13993003.congress-2020.138
VO 56
IS suppl 64
A1 Vanessa E. Murphy
A1 Megan Jensen
A1 Elizabeth Holliday
A1 Warwick Giles
A1 Helen Barrett
A1 Leonie Callaway
A1 Andrew Bisits
A1 Michael Peek
A1 Sean Seeho
A1 Alistair Abbott
A1 Paul Colditz
A1 Andrew Searles
A1 John Attia
A1 Michael Hensley
A1 Joerg Mattes
A1 Peter Gibson
YR 2020
UL http://erj.ersjournals.com/content/56/suppl_64/138.abstract
AB Background: Asthma exacerbations in pregnancy are associated with adverse perinatal outcomes. FENO-based management in pregnancy reduced asthma exacerbations in a previous trial. BLT examined whether FENO-based asthma management would improve perinatal outcomes.Methods: BLT was a multi-centre, parallel group, RCT of asthma management guided by a FENO algorithm versus usual care. 1200 pregnant women with doctor diagnosed asthma and symptoms, or medication use for asthma in the previous year, were randomised to usual care (baseline assessment of asthma and no treatment changes) or FENO-based management. In the intervention group, a modified FENO algorithm was applied each 6-12 weeks (FENO used to adjust ICS dose, long acting beta agonist added when symptoms uncontrolled). A composite adverse perinatal outcome (preterm birth, intrauterine growth restriction, perinatal mortality, neonatal hospitalisation) was assessed from hospital records (primary outcome). Exacerbations in pregnancy (admission, emergency department visit, unscheduled doctor visit or oral steroid course) were assessed postpartum.Results: Baseline characteristics were similar between usual care (n=599) and FENO (n=601) groups. Intention to treat analysis found no significant difference between groups for the composite perinatal outcome (25.6% usual care, 29.4% FENO, OR 1.21 [0.94, 1.56]), all components of the composite outcome, and maternal exacerbations (19.2% usual care, 16.1% FENO, OR 0.80 [0.58, 1.10]).Conclusion: FENO-guided asthma management had no effect on perinatal outcomes.Funding: NHMRC AustraliaFootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 138.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).