Maternal and infants outcomes in asthmatic pregnant women in Mosul

Abstract

Background: Asthma affects between 3% and 12% of pregnant women worldwide and the prevalence among pregnant women is rising, it’s often unrecognized and suboptimal treated. The course of asthma during pregnancy varies; it improves, remains stable, or worsens in similar proportion of women. The risk of an asthma exacerbation is high immediately postpartum, but the severity of asthma usually returns to the preconception level after delivery and often follows a similar course during subsequent pregnancies. Good control of asthma is essential for maternal and fetal wellbeing. Patients and Methods: A prospective cohort study was adopted to achieve the study aim. The study conducted from January 2003 through September 2003. Asthmatic and non-asthmatic pregnant women were randomly selected from the outpatient clinics, in patient clinics and emergency department of AlRazi Teaching Hospital in Mosul city, the data obtained including age, height and weight, parity and gravid, history with a clinical examination of respiratory system and history of maternal and fetal complications. These points were recorded in an especially designed collection form for all women examined after they were consent a form 102 asthmatics pregnant and 115 non-asthmatics pregnant were enrolled in the study; 92 and 93 of them respectively were followed to delivery by researcher and the assessment of maternal and fetal outcomes was done. Percentages, relative risk ratio, p-value and 95% confidence interval were calculated with SPSS version 18. Results: The age interval (25-34) represents 58.7% of the asthmatic pregnant. The first, second and third trimesters correspond to 6.2%, 32.6% and 60.8% of asthmatic pregnant respectively. Regarding the symptoms, the study shows that Dyspnoae is the most common symptoms among them follows by wheeze, cough and chest tightness and lastly expectoration with percentage of 65.2%. Moreover finds out that 59 (64.2%) had worsening of symptoms during the three trimesters of pregnancy, 28 (30.4%) had No change in the severity of asthma and remainder 5 (5.4%) of them show improvement. The adverse maternal outcomes; hyperemesis gravid arum (RR of 1.43), recurrent hospital admission (RR= 2.26) and the severity of asthma in pregnant women with boys (RR= 2.29) occurs with high significant association. Also the infant outcomes; that the wheezy chest, fetal death and congenital anomalies occur in high significant statistical association among the asthmatic pregnant group with RR (1.66, 1.72, and 1.66 respectively). Conclusion: Symptoms of asthmatic patients during the pregnancy are more severe than without pregnancy. The symptoms are more sever in third trimester, which are caused by mechanical factors and the severity of asthma is more in mothers bearing boys. More over some adverse maternal and infant outcomes were significant statistically associated with asthma.