TY - JOUR
T1 - Asthma Medication Regimens in Pregnancy
T2 - Longitudinal Changes in Asthma Status
AU - Rohn, Matthew C.H.
AU - Stevens, Danielle R.
AU - Kanner, Jenna
AU - Nobles, Carrie
AU - Chen, Zhen
AU - Grantz, Katherine L.
AU - Sherman, Seth
AU - Grobman, William A.
AU - Kumar, Rajesh
AU - Biggio, Joseph
AU - Mendola, Pauline
N1 - Funding Information:
This study was supported by the National Institutes of Health Intramural Research Program at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (clinical site contracts HHSN275201300013C to North-western University, HHSN275201300014C to the University of Alabama at Birmingham, and the Emmes Company for the Data Coordinating Center HHSN275201300026I, HHSN27500001, HHSN275000017) and the NIH Medical Research Scholars Program Fund.
Publisher Copyright:
© 2023 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Objective: This study aimed to assess the impact of common asthma medication regimens on asthma symptoms, exacerbations, lung function, and inflammation during pregnancy. Study Design: A total of 311 women with asthma were enrolled in a prospective pregnancy cohort. Asthma medication regimen was categorized into short-acting β agonist (SABA) alone, SABAtinhaled corticosteroid (ICS), SABAtICStlong-acting β agonist (LABA), and no asthma medications (reference). We evaluated asthma control at enrollment (< 15 weeks' gestation) and its change into trimesters 2 and 3, including per cent predicted forced expiratory volume in 1 second (%FEV1) and peak expiratory flow (%PEF), pulse oximetry, fractional exhaled nitric oxide (FeNO), asthma symptoms (asthma attacks/month, night symptoms/week), and severe exacerbations. Linear mixed models adjusted for site, age, race, annual income, gestational age, body mass index, and smoking, and propensity scores accounted for asthma control status at baseline. Results: Women taking SABAtICS and SABAtICStLABA had better first trimester % PEF (83.5% [75.7.91.3] and 84.6% [76.9.92.3], respectively) compared with women taking no asthma medications (72.7% [66.0.79.3]). Women taking SABAtICStLABA also experienced improvements in %FEV1 (t11.1%, p<0.01) in the third trimester and FeNO in the second (-12.3 parts per billion [ppb], p<0.01) and third (-11.0 ppb, p<0.01) trimesters as compared with the trajectory of women taking no medications.
AB - Objective: This study aimed to assess the impact of common asthma medication regimens on asthma symptoms, exacerbations, lung function, and inflammation during pregnancy. Study Design: A total of 311 women with asthma were enrolled in a prospective pregnancy cohort. Asthma medication regimen was categorized into short-acting β agonist (SABA) alone, SABAtinhaled corticosteroid (ICS), SABAtICStlong-acting β agonist (LABA), and no asthma medications (reference). We evaluated asthma control at enrollment (< 15 weeks' gestation) and its change into trimesters 2 and 3, including per cent predicted forced expiratory volume in 1 second (%FEV1) and peak expiratory flow (%PEF), pulse oximetry, fractional exhaled nitric oxide (FeNO), asthma symptoms (asthma attacks/month, night symptoms/week), and severe exacerbations. Linear mixed models adjusted for site, age, race, annual income, gestational age, body mass index, and smoking, and propensity scores accounted for asthma control status at baseline. Results: Women taking SABAtICS and SABAtICStLABA had better first trimester % PEF (83.5% [75.7.91.3] and 84.6% [76.9.92.3], respectively) compared with women taking no asthma medications (72.7% [66.0.79.3]). Women taking SABAtICStLABA also experienced improvements in %FEV1 (t11.1%, p<0.01) in the third trimester and FeNO in the second (-12.3 parts per billion [ppb], p<0.01) and third (-11.0 ppb, p<0.01) trimesters as compared with the trajectory of women taking no medications.
KW - asthma
KW - medication
KW - pregnancy
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U2 - 10.1055/s-0041-1727233
DO - 10.1055/s-0041-1727233
M3 - Article
C2 - 33882589
AN - SCOPUS:85104865224
SN - 0735-1631
VL - 40
SP - 172
EP - 180
JO - American journal of perinatology
JF - American journal of perinatology
IS - 2
ER -