This systematic review and meta-analysis sought to investigate if asthma exacerbations, oral corticosteroid use, or asthma severity are associated with prematurity and intrauterine growth restriction Cohort studies published between 1975 and March 11, 2012 were considered for inclusion.
138 publications were identified for possible inclusion, and 9 papers met the inclusion criteria, by reporting perinatal outcomes of interest (low birth weight (<2500 gm), preterm birth (< 37 weeks gestation unless otherwise stated), and small for gestational age (<10th percentile for gestational age and sex) in groups of asthmatic patients stratified by history of exacerbations, oral corticosteroid use, or asthma severity.
Maternal asthma exacerbations and oral corticosteroid use had a significant effect on outcomes including: low birth weight (RR3.02, 95%CI[1.87,4.89]) and RR 1.41,95%CI[1.04,1.93], respectively) and preterm delivery (RR 1.54, 95%CI[0.89,2.69] and (RR 1.51,95%CI[1.15,1.98], respectively). Moderate to severe asthma during pregnancy was associated with an increased risk of small for gestational age (RR 1.24, 95%CI[1.15,1.35]) and low birth weight (RR 1.15,95%CI[1.05,1.26]) infants.
These data suggest that asthma exacerbations, oral corticosteroid use, or asthma severity defined as moderate to severe may be associated with preterm delivery, low birth weight, and small for gestational age. Further studies on the effect of maternal asthma control on perinatal outcomes are warranted.
Authors: Namazy JA, Murphy VE, Powell H, Gibson PG, Chambers C, Schatz M
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