Can maternal weight affect asthma management outcomes in pregnancy?

Published online: July 10, 2019

Asthma affects 8-12% of pregnant women worldwide, and asthma flare-ups are common during pregnancy. Maternal asthma is associated with increased risks for poor pregnancy outcomes, such as premature birth and being born too small, and an increased risk of wheeze in the infant. Managing asthma using a biomarker of lung inflammation called fractional exhaled nitric oxide (FeNO) is the only strategy that has been demonstrated to reduce asthma flare-ups and improve infant outcomes. However, the effects of maternal body mass index or weight gain during pregnancy on outcomes following this novel management approach are unknown.  

In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Murphy et al examined data from the Managing Asthma in Pregnancy (MAP) trial, which was conducted in Newcastle, Australia. This trial examined asthma flare-ups in women randomly allocated to have their asthma treatment adjusted by either their symptoms and lung function (control group), or by their lung inflammation as well as symptoms and lung function (FeNO group).

In this new analysis, the authors found that the FeNO-based management approach reduced asthma flare-ups in pregnancy among mothers who were not obese, or who gained weight within the recommendations for pregnancy weight gain, compared to the symptoms-based management approach. However, for women who were obese, or gained more weight than recommended in pregnancy, the benefits of the novel management approach were lessened. The findings highlight the importance of weight management both before and during pregnancy in contributing to improved maternal and infant outcomes among women with asthma.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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