哮喘的诊断、严重程度、症状和治疗与先兆子痫的发病风险

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:hz_shenff
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OBJECTIVE: Existing studies relating asthma and preeclampsia provide conflic ti ng results, perhaps due to differences in study populations, varying definitions of asthma, and inadequate control for confounding, particularly asthma medicati on use. This prospective study examines associations between aspects of asthma ( diagnosis, severity, symptoms, and medication use) and risk of preeclampsia. MET HODS: A total of 1,708 pregnant women, of whom 656 had asthma diagnosis and 1,05 2 had no asthma diagnosis, were included in this analysis. Asthma symptoms, trea tment, and severity were classified according to Global Initiative for Asthma gu idelines. Hospital records were abstracted, and strict criteria were applied to classify women as preeclamptic based on National Heart, Lung, and Blood Institut e guidelines. RESULTS: There were 568 of 656 women with diagnosed asthma and 353 of 1,052 women without asthma diagnosis who had symptoms or took asthma medicat ion during pregnancy. Separate adjusted logistic regression models were run for different measures of asthma status: 1) asthma diagnosis; 2) overall Global Init iative for Asthma severity; 3) Global Initiative for Asthma symptom and treatmen t steps; and 4) Global Initiative for Asthma symptom step and medication type. W omen at increased risk of preeclampsia were those classified as Global Initiativ e for Asthma symptom step 3/4 compared with no symptoms (odds ratio 3.36, 95%co nfidence interval 1.24-9.14) and theophylline users (odds ratio 1.16 for every dose/month increase in use, 95%confidence interval 1.02-1.33). In contrast, ne ither a history of physician-diagnosed asthma nor Global Initiative for Asthma treatment step was associated with preeclampsia status. CONCLUSION: Our findings suggest that women with moderate to severe asthma symptoms, regardless of asthm a diagnosis or treatment, are at increased risk of preeclampsia compared with wo men with no symptoms. OBJECTIVE: Existing studies relating asthma and preeclampsia provide conflicting results, perhaps due to differences in study populations, varying definitions of asthma, and inadequate control for confounding, particularly asthma medicati on use. This prospective study examines associations between aspects of asthma , severity, symptoms, and medical use) and risk of preeclampsia. MET HODS: A total of 1,708 pregnant women, of whom 656 had asthma diagnosis and 1,05 2 had no asthma diagnosis, were included in this analysis. Asthma symptoms, trea tment, and severity were classified according to Global Initiative for Asthma gu idelines. Hospital records were abstracted, and strict criteria were applied to classify women as preeclamptic based on National Heart, Lung, and Blood Institut e guidelines. RESULTS: There were 568 of 656 women with diagnosed asthma and 353 of 1,052 women without asthma diagnosis who had symptoms or took asthma medicat ion during pregnancy. Separate a djusted logistic regression models were run for different measures of asthma status: 1) asthma diagnosis; 2) overall Global Initiation for Asthma severity; 3) Global Initiative for Asthma symptom and treatment steps; and 4) Global Initiative for Asthma symptom step and W omen at increased risk of preeclampsia were those classified as Global Initiativ e for Asthma symptom step 3/4 compared with no symptoms (odds ratio 3.36, 95% co nfidence interval 1.24-9.14) and theophylline users (odds ratio 1.16 for every dose / month increase in use, 95% confidence interval 1.02-1.33). In contrast, ne ither a history of physician-diagnosed asthma nor Global Initiative for Asthma treatment step was associated with preeclampsia status. CONCLUSION: Our findings suggest that women with moderate to severe asthma symptoms, regardless of asthm a diagnosis or treatment, are at increased risk of preeclampsia compared with wo men with no symptoms.
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