Asthmatic Women Research Articles

The association between age at natural menopause and risk of asthma among postmenopausal women from the Canadian Longitudinal Study on Aging.

This study aimed to investigate the association between age at natural menopause and incidence of asthma among postmenopausal Canadian women. Women between the ages of 45-85 yr were followed for a 10-yr period. Analysis was restricted to naturally postmenopausal women who are nonsmokers and did not have asthma prior to menopause. Age at natural menopause was examined using the following categories: 40-44, 45-49, 50-54 (reference), and ≥55. Survival analysis was utilized to determine time to onset of asthma. Multivariable Cox regression analysis was performed to assess the relationship between age at natural menopause and asthma after adjusting for covariates. The multivariable Cox regression analysis showed a 30% decreased risk of asthma in women with age at natural menopause of 40-44 yr compared with age at natural menopause of 50-54 yr with a hazard ratio of 0.7 (95% confidence interval: 0.49-0.95). Women with later ages at natural menopause may be at increased risk for asthma.

Analyzing spirometry profile of pulmonary function pattern among gestating women with bronchial asthma: A case–control study

Asthma is a widespread respiratory illness that affects millions of people worldwide, including pregnant women. Using spirometry testing, this study examines the effects of pregnancy on the lungs of pregnant women with and without bronchial asthma. The survey included 200 asthmatic pregnant women overall and 100 pregnant healthy women. FEV1, PEFR, FVC, and FEV1/FVC ratio, among other lung function indicators, were measured during the second and third trimesters of pregnancy. The findings show that pregnant women with asthma have significantly worse lung function than healthy pregnant women, with lower FEV1, PEFR, and FEV1% values. In addition, changes in lung function and body mass index (BMI) were observed between the second and third trimesters. The FEV1/FVC ratio remained largely stable, although both FVC and FEV1% decreased significantly. These results highlight the dynamic nature of lung function and BMI during pregnancy and also highlight the importance of monitoring these changes for the health of expectant mothers and their unborn children. To ensure maternal and fetal health, it is essential to understand these physiological changes, especially in people with asthma. Future evaluation of spirometry data should consider reference equations tailored to pregnant women. This will provide important insights into the complex relationship between respiratory health and pregnancy.

The Impact of Yoga on Peak Expiratory Flow Rate in Asthmatic Women

The Impact of Yoga on Peak Expiratory Flow Rate in Asthmatic Women

The Effect of Climate Changes Educational Program on Asthmatic Women's Health Knowledge and Practices in Outpatient Chest Clinic

The Effect of Climate Changes Educational Program on Asthmatic Women's Health Knowledge and Practices in Outpatient Chest Clinic

Effects of Pregnancy-Onset Asthma on Perinatal Outcomes: A Retrospective Cohort Study

BackgroundIt is unknown whether women with pregnancy-onset asthma are predisposed to worse pregnancy outcomes compared to women with pre-pregnancy asthma. ObjectiveTo explore whether pregnancy-onset asthma leads to worse perinatal outcomes compared with pre-pregnancy asthma. MethodsWomen who were discharged with a diagnosis of asthma and gave birth to a live singleton were included in this retrospective cohort analysis. Women were separated into groups based on whether the asthma was diagnosed during or before pregnancy. Clinical characteristics, perinatal outcomes, and asthma exacerbations (AE) between the two groups were compared. Results335 women were included in this study, of whom 39 (11.6%) had pregnancy-onset asthma and 296 had pre-pregnancy asthma. All the pregnant women in the pregnancy-onset group experienced asthma exacerbations (AE) during pregnancy. The proportion of chronic hypertension, chronic hypertension with superimposed preeclampsia, and spontaneous preterm births in the pregnancy-onset group was significantly higher than that in the pre-pregnancy asthma group. After adjusting for age, BMI, onset of asthma during pregnancy, and severity of AE through multivariate analysis, pregnancy-onset asthma was an independent risk factor for spontaneous preterm birth (aOR 7.71, 95% CI 1.30–46.12), severe AE was an independent risk factor for gestational hypertension and preeclampsia (aOR 3.58, 95% CI 1.30–9.87). ConclusionsDuring pregnancy, pregnancy-onset asthma in women is associated with an exacerbation of the condition. Obstetricians should be vigilant for signs of asthma onset during pregnancy. Other health-care providers should watch out for symptoms of gestational hypertension and preeclampsia in pregnant women with pre-existing or new-onset asthma.

Sex-specific associations between air pollutants and asthma prevalence in Japanese adults: a population-based study

ABSTRACT This study investigated the association between air pollutants and asthma prevalence in male and female Japanese adults. In this retrospective cross-sectional analysis, annual mean exposure levels of air pollutants, specifically nitrogen dioxide (NO2) and particulate matter with a median aerodynamic diameter ≤2.5 μm (PM2.5), were assessed at a local monitoring site. Multivariable logistic regression models, adjusted for genetic and/or lifestyle factors, were used to explore the association between air pollutants and asthma, with stratification by sex. A total of 1,497 participants aged ≥40 years were included. Their mean age was 65.9 ± 12.4 years, with 847 being women. Overall, 91 participants were diagnosed with asthma. In the multivariable model, ambient exposure levels of NO2 and PM2.5 were significantly associated with asthma in women but not in men. This study highlights sex as a significant determinant of the link between air pollutants and asthma exacerbation, particularly among female Japanese adults.

CHARACTERIZATION OF THE ROLE OF ESTROGEN RECEPTORS IN EXACERBATING AIRWAY HYPERRESPONSIVENESS

Clinical, animal, and epidemiological studies have suggested a higher prevalence of asthma in women than in men, implicating the sex steroids, most importantly, the estrogen in the lungs, as a key player. Estrogen is known to act through its alpha and beta receptors located on the lungs and several researchers have reported that they play a differential role in asthma. In this study, we evaluated the receptor-specific effect of estrogen in mediating Airway Hyperresponsiveness (AHR) using the estrogen receptors knock-out mice (Esr α KO and Esr β KO). Adult (8-10 weeks old) male and female C57BL/6J (WT), Esr α KO, and Esr β KO mice (n=2/8 per group) were challenged with 50 μl of House Dust Mite (HDM) solution (25 μg of HDM extract derived from two species, Dermatophagoides pteronyssinus and Dermatophagoides farinae) or vehicle (phosphate-buffered saline, PBS) intranasally for 5 weeks. At 72 hours after the last exposure, AHR was assessed through the Methacholine challenge (MCh) of varying doses (0, 3.13, 12.5, 25, 50, 100 mg/mL) using the flexiVent rodent ventilator system (SCIREQ) and immediately followed by the collection of bronchoalveolar lavage fluid (BALF) for the preparation of cytospin slides to analyze immune cells. Data analysis was done using GraphPad Prism 10.0.3, and the P-value < 0.05 was considered significant. Resistance (Rrs), Elastance (Ers), Conducting airway resistance (Rn), Tissue resistance (G), and Tissue elastance (H) were significantly increased ( P < 0.05) in male and female Esr β KO induced with HDM compared to PBS. Interestingly, Esr α KO HDM-induced mice showed a significant reduction in AHR only in the males and not the females, whereas it was not significantly different in the WT (males and females) exposed to HDM or PBS-induced. However, we observed that there was no statistically significant difference at P- value < 0.05 in the macrophage and lymphocyte count in the HDM-induced mice compared to the PBS in the estrogen receptor knockout mice and the WT. Eosinophil and neutrophil recruitments were observed in all the estrogen receptor knock-out groups exposed to HDM compared to the PBS but not in the WT, however, they were prominent in the Esr β KO but were not significant at P- value < 0.05. In conclusion, Esr β KO mice (males and females) showed declined lung function after exposure to allergens, indicating that Esr β plays an important role in AHR and understanding the mechanisms involved would help to develop novel therapeutics for the treatment of allergic airway inflammation in females. This study was supported by the National Heart Lung and Blood Institute: R01HL159764 (PS) and R03HL141618 (PS). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Progesterone amplifies allergic inflammation and airway pathology in association with higher lung ILC2 responses.

Perimenstrual worsening of asthma occurs in up to 40% of women with asthma, leading to increased acute exacerbations requiring clinical care. The role of sex hormones during these times remains unclear. In the current study, we used a translational approach to determine whether progesterone exacerbates allergic inflammation in the traditional chicken egg ovalbumin (OVA) model in BALB/c mice. Simultaneously, we used peripheral blood mononuclear cells (PBMC) from healthy human donors to assess the effects of progesterone on circulating group 2 innate lymphoid cells (ILC2). Briefly, lungs of ovariectomized (OVX) or sham-operated female (F-Sham) controls were implanted with a progesterone (P4, 25 mg) (OVX-P4) or placebo pellet (OVX-Placebo), followed by sensitization and challenge with ovalbumin (OVA). Progesterone increased total inflammatory histologic scores, increased hyper-responsiveness to methacholine (MCh), increased select chemokines in the bronchoalveolar lavage (BAL) and serum, and increased ILC2 and neutrophil numbers, along the airways compared with F-Sham-OVA and OVX-Placebo-OVA animals. Lung ILC2 were sorted from F-Sham-OVA, OVX-Placebo-OVA and OVX-P4-OVA treated animals and stimulated with IL-33. OVX-P4-OVA lung ILC2 were more responsive to interleukin 33 (IL-33) compared with F-Sham-OVA treated, producing more IL-13 and chemokines following IL-33 stimulation. We confirmed the expression of the progesterone receptor (PR) on human ILC2, and showed that P4 + IL-33 stimulation also increased IL-13 and chemokine production from human ILC2. We establish that murine ILC2 are capable of responding to P4 and thereby contribute to allergic inflammation in the lung. We confirmed that human ILC2 are also hyper-responsive to P4 and IL-33 and likely contribute to airway exacerbations following allergen exposures in asthmatic women with increased symptoms around the time of menstruation.NEW & NOTEWORTHY There is a strong association between female biological sex and severe asthma. We investigated the allergic immune response, lung pathology, and airway mechanics in the well-described chicken egg ovalbumin (OVA) model with steady levels of progesterone delivered throughout the treatment period. We found that progesterone enhances the activation of mouse group 2 innate lymphoid cells (ILC2). Human ILC2 are also hyper-responsive to progesterone and interleukin 33 (IL-33), and likely contribute to airway exacerbations following allergen exposures in women with asthma.

Chinese expert consensus on the diagnosis, treatment, and management of asthma in women across life.

The epidemiology and severity of asthma vary by sex and age. The diagnosis, treatment, and management of asthma in female patients are quite challenging. However, there is hitherto no comprehensive and standardized guidance for female patients with asthma. Corresponding search strategies were determined based on clinical concerns regarding female asthma. Search terms included "sex hormones and lung development", "sex hormone changes and asthma", "hormones and asthma immune response", "women, asthma", "children, asthma", "puberty, asthma", "menstruation, asthma", "pregnancy, asthma", "lactation, asthma", "menopause, asthma", "obesity, asthma", and "women, refractory, severe asthma". Literature was retrieved from PubMed/Medline, Embase, Cochrane Library, China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Data with the search date of July 30, 2022 as the last day. This consensus used the Grading of Recommendations Assessment, Development, and Evaluation to evaluate the strength of recommendation and quality of evidence. We collected basic research results and clinical evidence-based medical data and reviewed the effects of sex hormones, classical genetics, and epigenetics on the clinical presentation and treatment response of female patients with asthma under different environmental effects. Based on that, we formulated this expert consensus on the management of female asthma throughout the life cycle. This expert consensus on the management of asthma in women throughout the life cycle provides diagnosis, treatment, and research reference for clinical and basic medical practitioners.

Dietary antioxidants and flavonoids intake, and their association with inflammation and oxidative stress parameters in asthmatic women: a case-control study.

Asthma is more prevalent and severe in women, especially after puberty. Studies suggest a potential link between dietary antioxidants, inflammation, and oxidative stress. This study aimed to compare the dietary intake of antioxidants in asthmatic and healthy women, evaluating their potential associations with inflammation and oxidative stress. This study analyzed 30 asthmatic and 30 healthy women's lung function, anthropometry, biochemical parameters, and dietary antioxidant intake using a 161-itemized semi-quantitative food frequency questionnaire. Additionally, the study explored connections between serum inflammatory markers and oxidative stress indicators in relation to dietary intake of antioxidant nutrients and flavonoids. Asthmatic women exhibited higher serum IL-6 levels and lower total antioxidant status compared to healthy controls. Nevertheless, no significant differences were observed in dietary antioxidant micronutrient intake. Healthy controls demonstrated a notably higher intake of anthocyanidins compared to asthmatic women. Furthermore, the study identified a negative correlation between flavonol intake and serum total oxidant status, as well as between flavan-3-ols intake and serum oxidative stress index. Dietary differences in flavonoid and flavonoid-rich foods intake among asthmatic women may affect their serum IL-6 levels and oxidative stress. Promoting a diverse diet rich in flavonoids could benefit women with asthma by mitigating inflammation and oxidative stress.

The Effect of Obesity on Severity of Asthma: An Observational Prospective Study from Pakistan.

The current research study aimed to access the relationship between obesity and asthma exacerbations and severity among adult patients at the outpatient section of a federal hospital (PIMS) in Islamabad, Pakistan. A cross-sectional research study was carried out on 207 asthma adult patients belonging to different areas and ethnic groups from the country. The study setting was the PIMS hospital, which attracts patients from all over the country due to its facilities and cost-effective treatments. The body mass index (BMI) of asthma patients was calculated using the heights and weights of the study subjects. However, the pulmonary functions were calculated using a computerized spirometer i-e Spirolab III S/N 303681 in line with Winspiro PRO 7.1.version software. It presents the patient's forced vital capacity that expires in the first second of expiration to full (FEV1) in comparison to forced vital capacity (FVC) ratio, that is, Tiffeneau-Pinelli index was also recorded to determine the asthma severity. According to recent surveys, the overall prevalence of patients with overweight and obesity was 29.0% and 23.7%, respectively. A Chi-square test was used, and a statistically significant relationship was observed between BMI and asthma severity (P < 0.001). The adult obese female patients presented poor pulmonary functions. The average FEV1/FVC ratio presented significant variance among four different categories of BMI with P < 0.05. This difference was due to the normal BMI category as the Tiffeneau-Pinelli index, that is, FEV1/FVC in the normal BMI group was significantly lower as compared to that in underweight and obese patients. The study subjects presented raised asthma severity in accordance with the raised BMI. Obese patients presented comparatively raised asthma exacerbations. Moreover, a statistically significant association of gender difference was observed between obesity and asthma severity. It was concluded that adult asthmatic women with obesity presented raised asthma severity as compared to adult asthmatic males.

Phytoestrogen-Based Hormonal Replacement Therapy Could Benefit Women Suffering Late-Onset Asthma.

It has been observed that plasmatic concentrations of estrogens, progesterone, or both correlate with symptoms in asthmatic women. Fluctuations in female sex steroid concentrations during menstrual periods are closely related to asthma symptoms, while menopause induces severe physiological changes that might require hormonal replacement therapy (HRT), that could influence asthma symptoms in these women. Late-onset asthma (LOA) has been categorized as a specific asthmatic phenotype that includes menopausal women and novel research regarding therapeutic alternatives that might provide relief to asthmatic women suffering LOA warrants more thorough and comprehensive analysis. Therefore, the present review proposes phytoestrogens as a promising HRT that might provide these females with relief for both their menopause and asthma symptoms. Besides their well-recognized anti-inflammatory and antioxidant capacities, phytoestrogens activate estrogen receptors and promote mild hormone-like responses that benefit postmenopausal women, particularly asthmatics, constituting therefore a very attractive potential therapy largely due to their low toxicity and scarce side effects.

Adverse Events during Adulthood, Child Maltreatment, and Asthma among British Adults in the UK Biobank.

Rationale: Intimate partner violence and child maltreatment have been separately associated with asthma in adults. No study has concurrently examined of adulthood adverse events (including, but not limited to, intimate partner violence) and child maltreatment on asthma in adults. Objectives: To concurrently examine of adulthood adverse events and child maltreatment on asthma in adults. Methods: This was a cross-sectional study of adulthood adverse events and child maltreatment on current asthma in 87,891 adults 40-69 years old who participated in the UK Biobank. Adulthood adverse events were assessed using questions adapted from a national crime survey. Child maltreatment was ascertained using the Childhood Trauma Screener questionnaire. Current asthma was defined as physician-diagnosed asthma and current wheeze and was further classified as noneosinophilic or eosinophilic according to eosinophil count (<300 vs. ⩾300 cells per microliter). Results: In a multivariable analysis, participants who reported two or more types of adulthood adverse events had 1.19-1.45 times significantly higher odds of asthma than those who did not, whereas participants who reported two or more types of child maltreatment had 1.25-1.59 significantly higher odds of asthma than those who reported no child maltreatment. After stratification by sex, similar results were obtained for child maltreatment in women and men, whereas adulthood adverse events were only significantly associated with asthma in women. Similar findings were observed in analyses that were restricted to never-smokers and former smokers with <10 pack-years of smoking and in analyses of noneosinophilic and eosinophilic asthma. Conclusions: In a cohort of British adults, child maltreatment was associated with current asthma in men and women, whereas adulthood adverse events were associated with current asthma in women only. This was independent of cigarette smoking or eosinophil count.

Exogenous female sex steroid hormones and new-onset asthma in women: a matched case–control study

BackgroundEvidence on the role of exogenous female sex steroid hormones in asthma development in women remains conflicting. We sought to quantify the potential causal role of hormonal contraceptives and menopausal hormone therapy (MHT) in the development of asthma in women.MethodsWe conducted a matched case–control study based on the West Sweden Asthma Study, nested in a representative cohort of 15,003 women aged 16–75 years, with 8-year follow-up (2008–2016). Data were analyzed using Frequentist and Bayesian conditional logistic regression models.ResultsWe included 114 cases and 717 controls. In Frequentist analysis, the odds ratio (OR) for new-onset asthma with ever use of hormonal contraceptives was 2.13 (95% confidence interval [CI] 1.03–4.38). Subgroup analyses showed that the OR increased consistently with older baseline age. The OR for new-onset asthma with ever MHT use among menopausal women was 1.17 (95% CI 0.49–2.82). In Bayesian analysis, the ORs for ever use of hormonal contraceptives and MHT were, respectively, 1.11 (95% posterior interval [PI] 0.79–1.55) and 1.18 (95% PI 0.92–1.52). The respective probability of each OR being larger than 1 was 72.3% and 90.6%.ConclusionsAlthough use of hormonal contraceptives was associated with an increased risk of asthma, this may be explained by selection of women by baseline asthma status, given the upward trend in the effect estimate with older age. This indicates that use of hormonal contraceptives may in fact decrease asthma risk in women. Use of MHT may increase asthma risk in menopausal women.

Fertility Challenges in Asthmatic Women: Examining the Complexities of Pregnancy Loss, Infertility, and Assisted Reproductive Technologies.

Asthma is a prevalent chronic respiratory condition affecting a significant portion of women of reproductive age. While the impact of asthma on general health and well-being has been extensively studied, its association with fertility challenges in women remains an area of growing concern. This review article explores the complexities surrounding fertility challenges in asthmatic women, specifically focusing on pregnancy loss, infertility, and the utilization of assisted reproductive technologies (ARTs). Various factors contribute to the heightened risk of pregnancy loss in asthmatic women, including the systemic inflammation associated with asthma, suboptimal asthma control, medication usage, and comorbidities. The review highlights the need for multidisciplinary management approaches to optimize asthma control before and during pregnancy, reducing the risk of adverse pregnancy outcomes. Furthermore, the review investigates the potential impact of asthma on female fertility and the underlying mechanisms involved. Asthma-related factors, such as chronic inflammation, altered hormonal balance, and medication effects, may disrupt the delicate reproductive processes, leading to infertility. It emphasizes the importance of comprehensive fertility evaluations and personalized treatment strategies for asthmatic women experiencing difficulties conceiving. Additionally, the article explores the utilization of ARTs, including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), in asthmatic women. It discusses the safety considerations and potential challenges associated with these techniques, such as the impact of asthma medications on oocyte quality, the effects of hormonal stimulation on asthma control, and the risk of exacerbations during the IVF process. The review underscores the importance of collaborative efforts among healthcare providers, including allergists, pulmonologists, obstetricians, and fertility specialists, to ensure optimal management of asthmatic women seeking to conceive. It emphasizes the significance of preconception counseling, meticulous asthma control, appropriate medication management, and individualized fertility treatments to enhance the reproductive outcomes in this population.

Hormonal contraceptives are associated with an increase in incidence of asthma in women.

Use of exogenous female sex hormones is associated to development of asthma, but the question of whether the effect is protective or harmful remains unresolved. To investigate whether initiation of hormonal contraception was associated with development of asthma. We performed a register-based, exposure-matched cohort study including women who initiated hormonal contraceptive treatment of any kind between 10 and 40 years of age and compared the incidence of asthma with women who did not initiate hormonal contraceptives. Asthma was defined as two redeemed prescriptions of inhaled corticosteroids within two years. Data were analysed using Cox' regression models adjusted for income and urbanization. We included 184.046 women with a mean age of 15.5 years (SD 1.5), where 30669 initiated hormonal contraceptive treatment and 153377 did not. We found that initiation of hormonal contraceptives was associated with an increased hazard ratio of developing new asthma by 1.78 (95%CI 1.58-2.00; P<0.001). The cumulative risk of new asthma was 2.7% after three years among users of hormonal contraceptives compared to 1.5% in non-users. In the different subtypes of hormonal contraceptives, 2nd and 3rd generation contraceptives carried significant associations (second generation HR 1.76; 95%CI 1.52-2.03; P<0.001 and third generation HR 1.62 95%CI 1.23-2.12; P<0.001). The association with increased incidence was only seen in women below 18 years. In this study, first-time users of hormonal contraception had an increased incidence of asthma compared with non-users. Clinicians prescribing hormonal contraceptives should be aware that airway symptoms may develop.

The association of asthma and air pollution: Evidence from India

In the last two decades, air pollution has increased throughout India resulting in the deterioration of air quality. This paper estimates the prevalence of self-reported asthma in women aged 15–49 years and examines the link between outdoor air pollution and disease prevalence in India by combining satellite data on particulate matter (PM2.5) and the National Family Health Survey (NFHS-4), 2015–16. The results indicate that both indoor pollution as well as outdoor air pollution are important risk factors for asthma in women as both independently increase the probability of asthma among this group. Strategies around the prevention of asthma need to recognize the role of both indoor as well as outdoor air pollution. The other significant risk factors for asthma are smoking, second-hand smoking, type of diet and obesity.

PEAK EXPIRATORY FLOW RATE DURING VARIOUS PHASES OF MENSTRUAL CYCLE IN ASTHMATICS PRESENTING TO A TERTIARY CARE CENTRE

Introduction: Asthma is a chronic inflammatory lung disease characterized by airway hyper responsiveness and reversible airway obstruction. Worsening of asthma symptoms and pulmonary functions in relation to menstruation has been documented by some authors. Objectives: To determine peak expiratory flow rate during various phases of menstrual cycle among adult asthmatic women. Methods: A Prospective studyof1 year duration (July 2020 to June2021) A consecutive series of 100 patients with asthma, attending the outpatient clinic of department of chest diseases, satisfying inclusion criteria were included in the study. The socio demographic details and the relevant clinical details was collected using the socio demographic Performa prepared specifically for the study, Patients asked to record asthma symptom scores, morning Peak Expiratory Flow Rate (m-PEFR) (best out of 3 readings taken) daily during the one month screening period to identify women with and without pre-menstrual asthma Results And Discussion: From our study we found highest mean PEFR value is during post ovulatory phase. Lowest during perimenstrual phase. Fall in PEFR seen mostly during perimenstrual phase (43%). Then during preovulatory phase (34%). No such fall seen during periovulatory and postovulatory phase. Severe symptoms were present during perimenstrual phase (19%) and preovulatory phase (14%) only. Similarly, moderate symptoms also during perimenstrual (22%) and preovulatory phase (21%). Both severe and moderate symptoms were not seen during periovulatory and postovulatory phase. Conclusion: Premenstrual exacerbation of asthma occurs in a significant proportion of female adult asthmatics. Thus proper history including menstrual variation of asthma of all these patients should be taken for effective management.

Anxiety and depression in women with asthma prior to fertility treatment

ABSTRACT Objective We investigate symptoms of anxiety and depression among women with asthma prior to fertility treatment. Methods This is a cross-sectional study of women screened for eligibility to the PRO-ART study (RCT of omalizumab versus placebo in asthmatic women undergoing fertility treatment (NCT03727971)). All participants were scheduled for in vitro fertilization (IVF) treatment at four public fertility clinics in Denmark. Data on demographics and asthma control (ACQ-5) were obtained. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS-A and D, respectively) and defined as being present on both subscales if a score >7 was obtained. Spirometry, diagnostic asthma test, and measurement of fractional exhaled nitric oxide (FeNO) were conducted. Results A total of 109 women with asthma were included (mean age 31.8 ± 4.6 and BMI 25.5 ± 4.6). Most women had male factor infertility (36.4%) or unexplained infertility (35.5%). Twenty-two percent of the patients reported uncontrolled asthma (ACQ-5 score > 1.5). The mean HADS-A and HADS-D scores were 6.0 ± 3.8 (95% CI 5.3–6.7) and 2.5 ± 2.2 (95% CI 2.1–3.0), respectively. Thirty (28.0%) women reported anxiety symptoms, and four (3.7%) had concomitant depressive symptoms. Uncontrolled asthma was significantly associated with both depressive (p = 0.04) and anxiety symptoms (p = 0.03). Conclusions More than 25% of women with asthma prior to fertility treatment had self-reported symptoms of anxiety, and just below 5% had self-reported depressive symptoms, possibly related to uncontrolled asthma.

Inflammatory bowel disease and asthma. Results from the RHINE study

BackgroundAsthma and inflammatory bowel disease (IBD) are common inflammatory diseases. The aim of this study was to investigate the associations of IBD with asthma and respiratory symptoms. MethodsThis study is based on 13,499 participants from seven northern European countries that filled in a postal questionnaire on asthma, respiratory symptoms, IBD including ulcerative colitis and Crohn's disease and various lifestyle variables. ResultsThere were 195 participants with IBD. The prevalence of asthma (14.5 vs 8.1%, p = 0.001), different respiratory symptoms (range 11.9–36.8% vs range 6.0–18.6%, p < 0.005), non-infectious rhinitis (52.1 vs. 41.6%, p = 0.004) and chronic rhinosinusitis (11.6 vs 6.0%, p = 0.001) were higher in subjects with IBD than in those without IBD. In multivariable regression analysis, the association between IBD and asthma was statistically significant (OR 1.95 (95% CI 1.28–2.96)) after adjusting for confounders such as sex, BMI, smoking history, educational level and physical activity. There was a significant association between asthma and ulcerative colitis (adjusted OR 2.02 (95% CI 1.27–2.19)), and asthma but not Crohn's disease (adjusted OR 1.66 (95% CI 0.69–3.95)). A significant gender interaction was found with a significant association between IBD and asthma in women but not in men ((OR 2.72 (95% CI 1.67–4.46) vs OR 0.87 (95% CI 0.35–2.19), p = 0.038). ConclusionsPatients with IBD, particularly those with ulcerative colitis and female, have a higher prevalence of asthma and respiratory symptoms. Our findings indicate that it is important to consider respiratory symptoms and disorders when examining patients with manifest or suspected IBD.