An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy

作者：Grzeskowiak L E; Smith B; Roy A; Dekker G A; Clifton V L^*

来源：European Journal of Obstetrics & Gynecology and Reproductive Biology, 2016, 197: 48-53.

DOI：10.1016/j.ejogrb.2015.11.038

• Asthma management
• Pregnancy
• Nurse-led care
• Respiratory
• Asthma

Objective: We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subsequent perinatal outcomes.
Study design: Prospective, observational cohort study of pregnant asthmatic women attending a tertiary hospital antenatal clinic. Asthmatic women were recruited from the antenatal clinic and were followed prospectively with visits at 12, 20, 28 and 36 weeks gestation. A new nurse-led AMS was introduced offering asthma self-management education and support. Outcomes were compared between women recruited before and after the AMS was introduced (n = 89 and 80, respectively) and included; prevalence of exacerbations during pregnancy, asthma control throughout pregnancy and perinatal outcomes, including preterm birth and small-for-gestational-age (SGA).
Results: The relative risk for exacerbations (0.69; CI: 0.33-1.42), loss of control (0.67; CI 0.46-0.99) and persistent uncontrolled asthma (0.48; CI 0.26-0.9) were all reduced with attendance to AMS during pregnancy. AMS was associated with non-statistically significant reductions in asthma exacerbations (19.1-15.0%; p = 0.480) and uncontrolled asthma at >2 study visits (21.3-11.3%; p = 0.078).
Conclusions: These findings demonstrate the potential impact of an AMS in improving asthma control during pregnancy, supporting the need for an adequately powered RCT to determine its clinical-and cost-effectiveness.

• 出版日期2016-2