Abstract

LEBLANC, Ana  and  CASTRO, Eunice Dias de. Evolution and asthma control in pregnant women followed in an Immunoallergy department. Rev Port Imunoalergologia [online]. 2013, vol.21, n.2, pp.117-124. ISSN 0871-9721.

Background: Asthma can complicate pregnancy and the personal development is unpredictable. The aim of this study was to evaluate the evolution and control of asthma in pregnant followed in an Immunoallergy department. Methods: Retrospective analysis of clinical processes of asthmatics followed during pregnancy in an Immunoallergy department. The patients were observed monthly and performed spirometry, eNO (exhaled nitric oxide) and ACT® questionnaire. A subjective analysis of the evolution throughout pregnancy (classified as improvement / maintenance / deterioration) was done taking into account the previous data, symptoms, rescue medication, emergency care, systemic corticosteroid therapy and medication adjustment. Results: We included 26 pregnant women with asthma (76.9% also with rhinitis, 73.1% atopic), between 18 and 36 years (mean: 27.6 ± 4.9 years). During pregnancy and postpartum period (PP), the majority of pregnant women had normal lung function (FEV1> 80%). The likelihood of bronchial inflammation (assessed by eNO) declined throughout pregnancy and PP. ACT showed total asthma control in only 28.6% in the first trimester, 22.2% in the second and 30% in the third. For each evaluation, FEV1, eNO and ACT were combined (significant correlation found between FeNO/ ACT in the second quarter [p = 0.028]). Subjectively it was found that in the first trimester the majority (55.6%) of pregnant women worsened, in the second and third trimester and PP the majority remained stable (52.4%, 62.5% and 57.1%, respectively). Six pregnant needed emergency care and four required systemic corticotherapy. In the overall evaluation, one asthmatic improved during pregnancy, while 11 worsened. Conclusions: This study confirms that asthma can be complicated, unpredictably, by pregnancy. Even patients followed regularly in consultation showed different evolutions, with exacerbations and the need to adjust therapy. It thus reinforces the importance of a close follow-up of pregnant women with asthma by specialists to achieve and maintain better disease control.

Keywords : control; exacerbation; pregnancy.

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