Obesity and asthma during pregnancy: a systematic review and meta-analysis.

IF 9 1区医学 Q1 RESPIRATORY SYSTEM

European Respiratory Review Pub Date : 2025-06-11 Print Date: 2025-04-01 DOI:10.1183/16000617.0259-2024

Hirotaka Matsuzaki, Shinya Matsuzaki, Yutaka Ueda, Kensuke Fukuda, Satoko Matsuzaki, Kosuke Hiramatsu, Tsuyoshi Hisa, Aiko Okada, Kazuya Mimura, Hidenori Kage, Michiko Kodama

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Abstract

Objective: To assess the effect of obesity on the prevalence of asthma, obstetric outcomes and delivery outcomes in pregnant women with asthma.

Methods: A comprehensive systematic review and meta-analysis were conducted up to 31 March 2024, using four public search engines. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, both quantitative and qualitative data were collected and analysed.

Results: We included 11 studies from 2006 to 2022 involving 77 611 386 pregnant patients (3.1% had asthma). Obesity increased the odds of asthma (n=2; OR 2.42, 95% CI 1.14-5.15) and increased that of uncontrolled asthma (n=6; OR 1.29, 95% CI 1.11-1.50) in pregnant women. In an adjusted pooled analysis, pregnant women with asthma were more likely to develop hypertensive disorders of pregnancy (HDP) (n=3; adjusted OR (aOR) 1.21, 95% CI 1.10-1.34), gestational diabetes mellitus (GDM) (n=3; aOR 1.14, 95% CI 1.04-1.26), fetal growth restriction (FGR) (n=2; aOR 1.18, 95% CI 1.15-1.21), preterm birth (PTB) (n=2; aOR 1.26, 95% CI 1.25-1.27), caesarean delivery (CD) (n=3; aOR 1.22, 95% CI 1.11-1.33) and severe maternal morbidity (n=1; aOR 1.50, 95% CI 1.45-1.55). Three comparator studies that examined the effect of obesity on obstetric outcomes cited obesity as a risk factor for HDP (n=1; aOR 1.7, 95% CI 1.3-2.3), GDM (n=1; aOR 4.2, 95% CI 2.8-6.3) and CD (n=1; aOR 1.6, 95% CI 1.3-2.0) in pregnant women with asthma.

Conclusions: Pregnancy with asthma may increase the risk of HDP, GDM, FGR, PTB and CD, and obesity has the potential to further increase the risk of HDP, GDM and CD in pregnant women with asthma.

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妊娠期肥胖与哮喘：一项系统回顾和荟萃分析。

目的：评估肥胖对哮喘孕妇哮喘患病率、产科结局和分娩结局的影响。方法：利用4个公共搜索引擎，对截至2024年3月31日的数据进行综合系统评价和荟萃分析。根据系统评价和元分析指南的首选报告项目，收集和分析定量和定性数据。结果：我们纳入了2006年至2022年的11项研究，涉及77611386名孕妇（3.1%患有哮喘）。肥胖增加哮喘的几率(n=2；OR为2.42,95% CI为1.14-5.15)，且未控制的哮喘增加(n=6；OR 1.29, 95% CI 1.11-1.50)。在一项调整后的汇总分析中，患有哮喘的孕妇更容易发生妊娠期高血压疾病（HDP） (n=3；调整OR (aOR) 1.21, 95% CI 1.10-1.34)，妊娠期糖尿病（GDM） (n=3；aOR 1.14, 95% CI 1.04-1.26)，胎儿生长受限（FGR） (n=2；aOR 1.18, 95% CI 1.15-1.21)，早产（PTB） (n=2；aOR 1.26, 95% CI 1.25-1.27)，剖宫产（CD） (n=3；aOR 1.22, 95% CI 1.11-1.33)和严重孕产妇发病率(n=1；（or 1.50, 95% CI 1.45-1.55）。三个比较研究调查了肥胖对产科结局的影响，认为肥胖是HDP的一个危险因素(n=1；aOR为1.7,95% CI为1.3-2.3),GDM (n=1；aOR 4.2, 95% CI 2.8-6.3)和CD (n=1；aOR为1.6,95% CI为1.3-2.0)。结论：妊娠合并哮喘可增加HDP、GDM、FGR、PTB和CD的风险，肥胖有可能进一步增加哮喘孕妇HDP、GDM和CD的风险。

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来源期刊

European Respiratory Review Medicine-Pulmonary and Respiratory Medicine

CiteScore

14.40

自引率

1.30%

发文量

审稿时长

24 weeks

期刊介绍： The European Respiratory Review (ERR) is an open-access journal published by the European Respiratory Society (ERS), serving as a vital resource for respiratory professionals by delivering updates on medicine, science, and surgery in the field. ERR features state-of-the-art review articles, editorials, correspondence, and summaries of recent research findings and studies covering a wide range of topics including COPD, asthma, pulmonary hypertension, interstitial lung disease, lung cancer, tuberculosis, and pulmonary infections. Articles are published continuously and compiled into quarterly issues within a single annual volume.