TY - JOUR

T1 - Passive smoking is associated with poor asthma control during pregnancy

T2 - a prospective study of 500 pregnancies

AU - Grarup, Pernille A

AU - Janner, Julie H

AU - Ulrik, Charlotte Suppli

PY - 2014

Y1 - 2014

N2 - BACKGROUND AND AIM: Asthma and tobacco exposure is common among pregnant women. We investigated the effect of passive and active smoking on asthma control during pregnancy.METHODS: Prospective observational design. Patients had their asthma control, based on symptoms, use of medication, spirometry, and exhaled nitric oxide [FENO], assessed every four weeks during 2nd and 3rd trimester of pregnancy; data on tobacco exposure were also collected prospectively. The primary outcome was episodes of uncontrolled and partly controlled asthma during pregnancy (defined according to GINA-guidelines).RESULTS: A total of 500 pregnant women with asthma (mean age 30.8 years, range 17 to 44) were consecutively included, of whom 32 (6.4%), 115 (23.0%) and 353 (70.6%), respectively, were current smokers, ex-smokers and never smokers [NS]. Sixty-five NS (18.4%) reported passive tobacco exposure. NS with passive tobacco exposure had significantly lower FEV1% predicted (p<0.02) and FENO (p = 0.01) compared to NS without passive tobacco exposure. The relative risk [RR] of an episode of uncontrolled asthma during pregnancy was 4.5 (95% CI 2.7-7.5: p<0.001) in current and ex-smokers compared with never smokers, and 2.9 (95% CI 1.4-5.9; p = 0.004) in NS-women with passive tobacco exposure compared with NS-women not reporting passive tobacco exposure. Treatment with inhaled corticosteroids, most likely as a marker of more severe asthma, was also associated with a higher risk (RR 8.1, 95% CI 5.1-13.0; p<0.001) of an episode of uncontrolled asthma.CONCLUSION: Passive tobacco exposure in never smokers is associated with an increased risk of episodes of uncontrolled asthma during pregnancy, which is likely to have adverse effects on pregnancy outcome.

AB - BACKGROUND AND AIM: Asthma and tobacco exposure is common among pregnant women. We investigated the effect of passive and active smoking on asthma control during pregnancy.METHODS: Prospective observational design. Patients had their asthma control, based on symptoms, use of medication, spirometry, and exhaled nitric oxide [FENO], assessed every four weeks during 2nd and 3rd trimester of pregnancy; data on tobacco exposure were also collected prospectively. The primary outcome was episodes of uncontrolled and partly controlled asthma during pregnancy (defined according to GINA-guidelines).RESULTS: A total of 500 pregnant women with asthma (mean age 30.8 years, range 17 to 44) were consecutively included, of whom 32 (6.4%), 115 (23.0%) and 353 (70.6%), respectively, were current smokers, ex-smokers and never smokers [NS]. Sixty-five NS (18.4%) reported passive tobacco exposure. NS with passive tobacco exposure had significantly lower FEV1% predicted (p<0.02) and FENO (p = 0.01) compared to NS without passive tobacco exposure. The relative risk [RR] of an episode of uncontrolled asthma during pregnancy was 4.5 (95% CI 2.7-7.5: p<0.001) in current and ex-smokers compared with never smokers, and 2.9 (95% CI 1.4-5.9; p = 0.004) in NS-women with passive tobacco exposure compared with NS-women not reporting passive tobacco exposure. Treatment with inhaled corticosteroids, most likely as a marker of more severe asthma, was also associated with a higher risk (RR 8.1, 95% CI 5.1-13.0; p<0.001) of an episode of uncontrolled asthma.CONCLUSION: Passive tobacco exposure in never smokers is associated with an increased risk of episodes of uncontrolled asthma during pregnancy, which is likely to have adverse effects on pregnancy outcome.

U2 - 10.1371/journal.pone.0112435

DO - 10.1371/journal.pone.0112435

M3 - Journal article

C2 - 25409513

VL - 9

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 11

M1 - e112435

ER -