Asthma and gestational diabetes affect perinatal outcomes, but not synergistically

Published online April 22, 2025

Asthma and Gestational Diabetes Mellitus (GDM) are common conditions in pregnancy which are both associated with poor pregnancy and neonatal outcomes. Previous work has shown that women with asthma are at increased risk of developing GDM in pregnancy. This may be due to maternal obesity, which is common in mothers with asthma in pregnancy. Since both asthma and GDM are associated with poor outcomes, such as preeclampsia and preterm birth, we aimed to determine whether the adverse perinatal effects of having both conditions was greater than having either asthma or GDM alone. 

In a recent issue of The Journal of Allergy and Clinical Immunology: In Practice, Jensen and colleagues explored the relationships between asthma and GDM and poor perinatal outcomes using a population-based cohort of >40,000 pregnancies in Australian women between 2018 and 2020. Data from singleton births to mothers who were 18 years of age and older were extracted from electronic obstetric records across two health districts. The authors determined whether asthma was associated with GDM risk, and whether asthma alone, GDM alone, and asthma with GDM were associated with poor pregnancy outcomes, including hypertensive disorders of pregnancy, cesarean birth, preterm birth, neonatal birth, low birth weight, macrosomia, infant respiratory distress syndrome and congenital anomalies. 

The results showed that, once adjusted for potential confounders, including maternal obesity, there was no association between maternal asthma and GDM risk. Asthma alone was associated with increased risks for preterm birth, low birth weight and congenital anomalies, cesarean birth and infant respiratory distress at birth. GDM alone was also associated with cesarean birth and infant respiratory distress. Having both asthma and GDM increased the risk for hypertensive disorders of pregnancy, cesarean birth and infant respiratory distress compared to not having asthma or GDM. Statistically, there were no synergistic effects of both asthma and GDM on any of the pregnancy or neonatal outcomes. The results in this contemporary cohort reinforce that maternal asthma is associated with poor perinatal outcomes and closer monitoring is potentially warranted for women with both asthma and GDM. 

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

Full Article