Asthma Is Associated With Pregnancy Loss and Recurrent Pregnancy Loss: A Nationwide Cohort Study

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Background: Women with asthma appear to have an increased risk of pregnancy loss (PL). The impact of asthma on recurrent pregnancy loss (RPL), defined as 3 consecutive losses, is, however, unknown. Objective: The aim of this study was to investigate whether having asthma before or during the fertile age is associated with PL and RPL. Methods: Based on Danish national health registers, we identified all women aged 6 to 45 years with at least 2 filled prescriptions of an antiasthma drug during the period 1977 to 2019. Women with asthma were compared with women without asthma. Pregnancy outcomes were retrieved for both groups from national health registers. Logistic regression with adjustment for the year of birth and educational level provided odds ratios (ORs) for the number of PLs. Subgroup analyses were conducted for early-onset (age 6–15 years), adult-onset (age 16–39 years), and late-onset (age 40–45 years) asthma. Lastly, we compared uncontrolled asthma (defined as ≥ 400 doses of a short-acting beta-2 agonist in a year) to controlled asthma (defined as < 400 doses of a short-acting beta-2 agonist in a year). Results: In a population of 1,309,786 women, we identified 128,553 women with asthma and 1,297,233 women without asthma. Compared with nonasthmatic women, women with asthma had ORs for 1, 2, and 3 or more PLs of 1.05 (95% CI 1.03–1.07), 1.09 (95% CI 1.05–1.13), and 1.18 (95% CI1.11–1.24), respectively, and for RPL of 1.19 (95% CI 1.12–1.27). In women with early-onset asthma, the OR of 3 or more PLs was 1.47 (95% CI 1.24–1.72). For women classified as having uncontrolled asthma compared with controlled asthma, we found a significant OR of 1.60 (95% CI 1.16–2.16) for 3 or more PLs. Conclusions: We found a significant positive association between asthma and number of PLs and RPLs. Early-onset asthma and uncontrolled asthma were more strongly associated with PL than adult-onset and late-onset asthma and controlled asthma.

OriginalsprogEngelsk
TidsskriftJournal of Allergy and Clinical Immunology: In Practice
Vol/bind10
Udgave nummer9
Sider (fra-til)2326-2332.e3
ISSN2213-2198
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
Conflicts of interest: C. Tidemandsen has received speaker’s fee from TEVA Pharmaceutical Industries Ltd and a grant from Novartis CIGE025ADK01T PROART. C. S. Ulrik has attended advisory boards for AstraZeneca, ALK-Abello, GlaxoSmthKilne (GSK), Boehringer-Ingelheim, Novartis, Chiesi, TEVA, and Sanofi-Genzyme; has given lectures at meetings supported by AstraZeneca, Sandoz, Mundipharma, Chiesi, Boehringer-Ingelheim, Orion Pharma, Novartis, TEVA, Sanofi-Genzyme, and GSK; has taken part in clinical trials sponsored by AstraZeneca, Novartis, Merck, InsMed, ALK-Abello, Sanofi-Genzyme, GSK, Boehringer-Ingelheim, Regeneron, Chiesi, and Novartis; and has received educational and research grants from AstraZeneca, MundiPharma, Boehringer-Ingelheim, Novartis, TEVA, GSK, and Sanofi-Genzyme. D. Westergaard has received the following grants from Novo Nordisk Foundation NNF18SA0034956, NNF14CC0001, and NNF17OC0027594. The rest of the authors declare that they have no relevant conflicts of interest.

Publisher Copyright:
© 2022 American Academy of Allergy, Asthma & Immunology

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