QOL in Pregnant Women With Asthma Affected by Disease Control, Severity

Between 8% and 13% of pregnant women have asthma, which may affect quality of life (QOL). A recently published study discussed whether asthma control and severity are linked with QOL in pregnant women in Iran.

Researchers used the Asthma Control Questionnaire (ACQ) and the Asthma Quality of Life Questionnaire (AQLQ) and the guidelines of the Global Initiative for Asthma in order to assess asthma severity.

The prospective study in pregnant women with and without asthma was conducted from August 2014 to June 2015; participants had visited an antenatal clinic during the end of the first trimester of their pregnancy.

Patients with suspected asthma had their diagnosis confirmed through spirometry with a pulmonologist. They were divided into 2 groups: intermittent asthma and mild persistent asthma (IMPA) or moderate and severe persistent asthma (MSPA).

The women visited the asthma specialist clinic several times during pregnancy, where they took both the 5-item version of the ACQ and the 32-item version of the AQLQ.

All patients were required to do self-monitoring peak flow measurements and to record these for 2 weeks after each asthma specialist clinic visit or after a worsening of symptoms. Inhaled glucocorticoids and any other drug intake were recorded for each trimester during pregnancy.

Among 1603 pregnant women, 34 received an asthma diagnosis. By severity level, of the 34:

• 13 had intermittent asthma
• 10 had mild asthma
• 8 had moderate asthma
• 3 had severe persistent asthma

Overall, 11 (32%) women had MSPA, while 23 (68%) had IMPA. Thirteen women (38%) had well-controlled asthma, and 21 (62%) had partly/poorly controlled asthma.

Pregnant women with asthma were an average 4 years older than women without asthma (P = .001), and so were more often to have had successful prior pregnancies (P = .017) and more previous spontaneous abortions (P = .033).

No statistically significant differences were found for weight gain during pregnancy and for weeks of gestation at delivery.

Results showed a significant decrease of QOL with poorer asthma control (P = .014). This decline could be due to limitations of activity in those with poorer asthma control, which is underlined by the significant decline of QOL with increasing asthma severity (P = .024).

Most women had at least partly favorable QOL, and asthma control was significantly related to asthma-related QOL.

Women with asthma that was not well controlled and lower QOL may have been partly due to worse pulmonary function limiting their physical activity

The researchers said the findings stress “the importance of controlling asthma during pregnancy, not only for the prevention of adverse pregnancy outcomes but also for the preservation of QOL.”

Reference

Fazel N, Kundi M, Jensen-Jarolim E, et al. Quality of life and asthma control in pregnant women with asthma. BMC Pulm Med. Published online December 17, 2021. doi:10.1186/s12890-021-01797-9