Historical cohort studies examining the effect of maternal asthma on pregnancy outcomes
Author yr [ref] | Population study yrs | Asthma definition | Sample size | ICS use | Poor outcomes associated with asthma | Poor outcomes not associated with asthma |
Gordon et al., 1970 9 | USA | Actively treated asthma | 30861 (all) 277 (asthma) | Prior to ICS | Perinatal death (severe asthma) | Low birth weight |
Bahna and Bjerkedal, 1972 10 | Norway 1967–1968 | Mother's health documented by midwife or physician in birth registry | 112530 (control) 381 (asthma) | Prior to ICS | Pre-term delivery, low birth weight, hyperemesis, haemorrhage, toxemia, induced/complicated labour, neonatal mortality | |
Lao and Huengsburg, 1990 11 | Hong Kong 1984–1987 | History of asthma | 87 (control) 87 (asthma) | 11% used beclomethasone | Low birth weight (mothers not receiving treatment for asthma), C-section (mothers using bronchodilators) | |
Perlow et al., 1992 12 | USA 1985–1990 | Asthma diagnosis reported in perinatal database | 130 (control) 81 (asthma) | Unclear | C-section for foetal distress, pre-term labour and delivery, pre-term premature rupture of membranes, gestational diabetes (steroid-dependent asthma), low birth weight (steroid-dependent asthma) | Pre-eclampsia, chronic hypertension, congenital malformations, IUGR |
Lehrer et al., 1993 13 | USA 1987–1991 | Asthma history or asthma requiring treatment | 22680 (control) 1435 (asthma history), 136 (asthma with treatment) | 136 used ICS | Pregnancy-induced hypertension | |
Demissie et al., 1998 14 | USA 1989–1992 | Asthma diagnosis recorded in database | 9156 (control) 2289 (asthma) | Unknown | Pregnancy-induced hypertension, pre-eclampsia, low birth weight, pre-term delivery, congenital malformations | Post-partum haemorrhage |
Alexander et al., 1998 1 | Canada 1991–1993 | Completed on prenatal records or maternal admission forms | 13709 (control) 817 (asthma) | Unclear | Antepartum and post-partum haemorrhage | C-section, gestational diabetes, pre-term delivery, pregnancy-induced hypertension |
Kallen et al., 2000 15 | Sweden 1984–1995 | Recorded by midwife | 36985 (all pregnant females) 15512 (asthma) | Unknown | Pre-term delivery, low birth weight, post-term birth, infant death | Congenital malformations |
Wen et al., 2001 16 | Canada 1989–1996 | Diagnosis recorded in database | 34688 (control) 8672 (asthma) | Unknown | Pre-term labour, pre-eclampsia, pregnancy-induced hypertension, antepartum and post-partum haemorrhage, premature rupture of membranes, C-section | Foetal death |
Liu et al., 2001 17 | Canada 1991–1996 | Diagnosis recorded in database | 8772 (control) 2193 (asthma) | Unknown | Small for gestational age, pregnancy-induced hypertension, chorioamnionitis, pre-eclampsia, pre-term delivery | Congenital malformations |
Olesen et al., 2001 18 | Denmark 1991–1996 | Primiparae females with diagnosis of asthma and purchase of prescription drugs for asthma | 8717 (control) 303 (asthma) | 22.5% used ICS | Small for gestational age (theophylline users), reduced birth weight and length (mothers who reduced intensity of drug treatment during pregnancy) | Congenital malformations |
Norjavaara and de Verdier, 2003 19 | Sweden 1995–1998 | Self-report | 293948 (all) 2968 (asthma) | All used budesonide | C-section | Still birth, congenital malformations, reduced birth weight, reduced gestational length |
ICS: inhaled corticosteroid; C-section: caesarean section; IUGR: intrauterine growth restriction.