Effect of asthma exacerbation during pregnancy in women with asthma: a population-based cohort study

The association between asthma exacerbation (AE) during pregnancy and adverse maternal and child health outcomes have not been appropriately investigated. Our objective was to determine the short- and long-term intergenerational effect of AE in pregnant women with asthma.

A population cohort study was conducted using data from the Ontario asthma surveillance system and population-level health administrative data. AE in pregnant women with asthma was defined as at least one of the following criteria: ≥5 physician visits, or 1 emergency department visit, or 1 hospital admission for asthma during pregnancy. Pregnancy complications, adverse perinatal outcomes, and early childhood respiratory disorders were identified using ICD codes 9th and 10th Revisions.

The cohort consisted of 103 424 singleton pregnancies in women with asthma. AE in pregnant women with asthma was associated with higher odds of preeclampsia (OR 1.30; 95% CI 1.12, 1.51), and pregnancy induced hypertension (OR 1.17; 95% CI 1.02, 1.33); babies had higher odds of low birth weight (OR 1.14; 95% CI 1.00, 1.31), being pre-term (OR 1.14; 95% CI 1.01, 1.29), and congenital malformations (OR 1.21; 95% CI 1.05, 1.39). Children born to women with AE during pregnancy had elevated risk of asthma (OR 1.23; 95% CI 1.13, 1.33) and pneumonia (OR 1.12; 95% CI 1.03, 1.22) during first 5 years of life.

AE during pregnancy in women with asthma showed increased risk of pregnancy complications, adverse perinatal outcomes and early childhood respiratory disorders in their children, indicating appropriate asthma management may reduce the risk of adverse health outcomes.