Abstract
Objective
To study the characteristics of the infants born to women who have used anti-asthmatic drugs during pregnancy.
Material and methods
Various characteristics of infants with mothers who had reported the use of anti-asthmatic drugs in early pregnancy (n = 24,750) or had such drugs prescribed later during pregnancy by a maternity health care centre (n = 7 63) were identified from the Swedish Medical Birth Register and compared to those of all infants. Risks estimated with Mantel-Haenszel technique were expressed as odds ratios (OR) with 95% confidence intervals after adjustment for a number of putative confounders. The severity of maternal asthma was assessed on the basis of the number of anti-asthmatic drugs used.
Results
An increased risk for preterm birth, low birth weight and small for gestational age was found, which increased with the number of anti-asthmatic drugs used by the mother during pregnancy (OR = 1.46, 1.67, and 1.70, respectively, when three or more drugs had been used). An increased risk for large for gestational age could be explained by the effect of gestational diabetes and high body mass index. An increased risk for neonatal icterus was mainly an effect of preterm birth, while an increased risk for respiratory problems and/or low Apgar score (OR = 1.43) was only slightly reduced in full-term infants. An increased risk for hyperglycaemia (OR = 1.62) was not explained by confounding from maternal diabetes. No risk increase was found for neonatal convulsions or cerebral haemorrhage. Mortality was increased only among infants whose mother had used three or more anti-asthmatic drugs (OR = 1.52).
Conclusion
Infants whose mothers had asthma had a number of manifestations of poor outcome which appeared to be linked with the severity of the asthma.
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References
Lao TT, Huengsburg M (1990) Labour and delivery in mothers with asthma. Eur J Obstet Gynecol Reprod Biol 35:183–190
Perlow JH, Montgommery D, Morgan MA, Towers CV, Porto M (1992) Severity of asthma and perinatal outcome. Am J Obstet Gynecol 167:963–967
Doucette JT, Bracken MB (1993) Possible role of asthma in the risk of preterm labor and delivery. Epidemiology 4:143–150
Demissie K, Breckenridge MB, Rhoads GG (1998) Infant and maternal outcomes in the pregnancies of asthmatic women. Am J Respir Crit Care Med 158:1091–1095
Källén B, Rydhstrom H, Åberg A (2000) Asthma during pregnancy – a population based study. Eur J Epidemiol 16:167–171
Liu S, Wen SW, Demissie K, Marcoux S, Kramer MS (2001) Maternal asthma and pregnancy outcomes: a retrospective cohort study. Am J Obstet Gynecol 184:90–96
Schatz M, Zeiger RS, Hoffman CP, Harden K, Forsythe A, Chilingar L, Saunders B, Porreco R, Sperling W, Kagnoff M, Benenson AS (1995) Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis. Am J Respir Crit Care Med 151:1170–1174
Minerbi-Codish I, Fraser D, Avnun L, Glezerman M, Heimer D (1998) Influence of asthma in pregnancy on labor and the newborn. Respiration 65:130–135
Olesen C, Thrane N, Lauge Nielsen G, Sørensen HT, Olsen J for the EuroMap Group (2001) A population-based prescription study of asthma drugs during pregnancy: changing the intensity of asthma therapy and perinatal outcome. Respiration 68:256–261
Sheiner E, Mazor M, Levy A, Wiznitzer A, Bashiri A (2005) Pregnancy outcome of asthmatic patients: a population-based study. J Maternal-Fetal Neonat Med 18:237–240
Stenius-Aarniala B, Piirilä P, Teramo K (1998) Asthma and pregnancy: a prospective study of 198 pregnancies. Thorax 43:12–18
Stenius-Aarniala B, Riikonen S, Teramo K (1995) Slow-release theophylline in pregnant asthmatics. Chest 107:642–647
Alexander S, Dodds L, Armson BA (1998) Perinatal outcomes in women with asthma during pregnancy. Obstet Gynecol 92:435–440
Schatz M (2001) The efficiacy and safety of asthma medications during pregnancy. Seminar Perinatol 25:145–152
Norjavaara E, Gerhardsson de Verdier M (2003) Normal pregnancy outcomes in a population-based study including 2968 pregnant women exposed to budesonide. J Allergy Clin Immunol 11:736–742
Wen SW, Demissie KW, Liu S (2001) Adverse outcomes in pregnancies of asthmatic women: results from a Canadian population. Ann Epidemiol 11:7–12
Källén B, Otterblad Olausson P (2007) Use of anti-asthmatic drugs during pregnancy. Maternal characteristics, pregnancy and delivery complications. Europ J Clin Pharmacol (in press)
National Board of Health and Welfare. Centre for Epidemiology. The Swedish Medical Birth Register-a summary of content and quality. Available at: http://www.sos.se/FULLTEXT/112/2003-112-3/2003-112-3.pdf
Källén B (1995) A birth weight for gestational age standard based on data in the Swedish medical birth registry 1985-1989. Eur J Epidemiol 11:601–606
Källén K (1999) Maternal smoking and congenital malformations. PhD dissertation, University of Lund, Lund
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Källén, B., Olausson, P.O. Use of anti-asthmatic drugs during pregnancy. 2. Infant characteristics excluding congenital malformations. Eur J Clin Pharmacol 63, 375–381 (2007). https://doi.org/10.1007/s00228-006-0258-0
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DOI: https://doi.org/10.1007/s00228-006-0258-0