SELECTED ARTICLES FROM THE RECENT LITERATURE 2004

11/24/04

Association of asthma with risk for pre-eclampsia in pregnancy

Summary
Background - Previous studies have yielded different conclusions whether there is an increased risk for pre-eclampsia (Pr-cl) in pregnant asthmatics, possibly due to study design differences.

Findings - Triche et al of Yale Univ carried out a medical record review of 1,708 previously pregnant women in whom 656 had asthma diagnosis and 1,052 had no asthma diagnosis. The authors assessed asthma severity and made several logression models, adjusting for use of asthma medications.

The authors found no increased risk for Pre-cl in those just previously diagnosed as asthmatic. However, such risk for Pre-cl was definitely increased (Odds Ratio = 3.36) in those with more severe asthma symptoms by GINA classification criteria. There was also an association of increasing theophylline dose with an increased risk for Pre-cl.

Conclusions - Women with moderate to severe asthma symptoms regardless of treatment are at increased risk for Pre-cl when compared to gestation-matched women with no asthma symptoms.

Reference
Obstet Gynecol 2004;104:585-93

Editor's Comments
As pointed out by these authors, different results in previous studies in this area may reflect different patient populations and criteria used for the diagnosis of asthma and asthma severity. I think that most experienced clinicians and investigators feel that women with uncontrolled asthma are at increased risk for pregnancy complications. This point must be emphasized to pregnant asthmatics who are reluctant to use inhaled corticosteroids that might well control their asthma because of a "steroidophobia."

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