Asthma in pregnancy: Reading between the lines
Cathy Benninger MS, RN, CNP, AE-C
Jennifer McCallister MD

$7.95 		The Nurse Practitioner: The American Journal of Primary Health Care
April 2010 
Volume 35  Number 4
Pages 10 - 19
 
  PDF Version Available!

ABSTRACT
Asthma, a chronic respiratory disease characterized by variable bronchial inflammation, airflow obstruction, and hyperresponsiveness, is estimated to affect 15.7 million American adults, or 7.2% of the general adult population.1 After the age of 17, women have a 40% higher asthma prevalence rate than men.1 In addition, women experience significantly more asthma attacks and are hospitalized 35% more often for asthma.1 Although asthma mortality has declined slightly since 2000, death rates in 2003 were 200% higher for non-Hispanic blacks compared to non-Hispanic whites, and 45% higher for females than for males.1Asthma is one of the most common, chronic medical conditions that can complicate pregnancy, affecting between 4% and 8% of this population.2 Adverse pregnancy outcomes can be related to poor asthma control, and severe maternal asthma has been associated with an increased risk of infant death, preeclampsia, premature birth, and low birth weight.3Improved pregnancy outcomes are closely associated with well-controlled asthma and aggressive treatment of exacerbations during pregnancy. The goal of therapy is to maintain optimal control of asthma for maternal health and well-being, as well as normal fetal maturation throughout gestation.3 Treatment is based on frequency of symptoms and introduced in a stepwise approach similar to asthma management in nonpregnant adults. To help guide the medical community in the management of asthma and improve maternal and fetal outcomes, several national and international groups have published evidence-based recommendations. The American College of Obstetricians and Gynecologists (ACOG) practice bulletin for managing asthma in pregnancy is the most recent set of guidelines published. The ACOG practice bulletin emerged from recommendations published in the Expert Panel 3 Guidelines for the Diagnosis and Management of Asthma4 and the National Asthma Education and Prevention Program's Asthma and Pregnancy

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