Published Online: January 5, 2016
Asthma is associated with a higher risk for a number of poor pregnancy outcomes including preterm birth and low birthweight. Effective management of asthma is believed to reduce the risk for pregnancy-related complications. Therefore during pregnancy, the goal is to maintain asthma control. The Asthma Control Test is a simple patient self-administered questionnaire used to assess asthma control.
A study appearing in The Journal of Allergy and Clinical Immunology: In Practice evaluated whether a specially adapted version of the Asthma Control Test for pregnancy, the Pregnancy Asthma Control Test, is a valid tool to assess asthma control in women during pregnancy over the telephone. The Pregnancy Asthma Control Test contains five questions and results in a score between 5-25, with a higher score indicating more control. Palmsten and colleagues from the University of California, San Diego and Kaiser Permanente Medical Center in San Diego studied 159 pregnant women with asthma enrolled in the MotherToBaby Pregnancy Studies between 2011 and 2013. Women were interviewed by telephone at up to three time points during pregnancy and once after pregnancy. Women were asked about their symptoms, their asthma rescue medication use, the impact of their asthma on activities, and changes in their asthma between telephone interviews.
At the time of enrollment in the study during early pregnancy, women with well-controlled asthma had an average score of 23.2 compared with an average score of 13.7 among women with very poorly controlled asthma. Women who reported that their asthma was much better at mid-pregnancy compared with early pregnancy had an average score increase of 4.7, whereas women who reported that their asthma was a little worse had an average decrease of 1.3. A lower Pregnancy Asthma Control Test score was associated with previous asthma exacerbations. However, the Pregnancy Asthma Control Test at the time of enrollment did not predict future exacerbations during pregnancy. Reliability was rated as being good across each study time point.
This study suggests that the Pregnancy Asthma Control Test administered to patients over the telephone is reliable and valid for assessing asthma control during pregnancy. The telephone test may be clinically useful for measuring asthma control during pregnancy. The study’s authors suggest that future studies should evaluate whether using the Pregnancy Asthma Control Test leads to timely clinical interventions and improved asthma control during pregnancy.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.