Predictors of low risk of asthma exacerbation during pregnancyA prospective study of 1,283 pregnancies

Abstract

Background: Monthly assessment of asthma control is recommended throughout pregnancy to reduce the risk of exacerbations, and by that risk of adverse outcome. Objective: To identify pregnancies with low risk of asthma exacerbation during pregnancy. Methods: All pregnant women referred to Hvidovre Hospital have been offered enrolment into the Management of Asthma during Pregnancy (MAP) program since 2007. Assessment of asthma control, adjustment of treatment, spirometry and measurement of exhaled nitric oxide (FENO) were performed, and information on exacerbation history was collected at the first visit. Characteristics of pregnancies with low risk of exacerbations were identified by univariate and multiple logistic regression analysis with stepwise backward elimination. Results: In 1,283 pregnancies, 107 exacerbations were observed with eight pregnancies complicated by more than one exacerbation. Multiple regression analysis revealed that no history of pre-pregnancy exacerbations (p Conclusion: No history of previous asthma exacerbations, only prescribed rescue bronchodilator and having well-controlled asthma at baseline visit is associated with low risk of an asthma exacerbation during pregnancy. This may guide clinicians in individualizing the frequency of follow-up visits in pregnant women with asthma.