Preterm birth risks in pregnant women with asthma

Abstract

Overview of the topic: Asthma is a serious health condition with socioeconomic implications. It was estimated that it affects 235 million individuals all over the world (World Health Organisation, 2019). Moreover, it is considered to be the most common illness to affect pregnancy, with an occurrence of between 4% and 8% in the European region (Charlton, Pierini, Klungsøyr, Neville, Jordan, Thayer and Engeland, 2016). Findings have shown that expecting mothers with asthma have an increased risk of adverse perinatal outcomes, such as preterm birth. However, sound control of asthma management is associated with mitigating risks. The research question: Does maternal asthma during pregnancy increase the risk of preterm birth? The PEO elements: The population (P) studied comprised pregnant mothers. The exposure (E) observed was asthmatic mother. The concluding anticipated outcome (O) was preventing preterm birth. Inclusion and exclusion criteria: These criteria were applied in order to assess the eligibility of the articles retrieved for this dissertation. The main inclusion criteria are pregnant mothers who are suffering from maternal asthma and preterm birth. Exclusion criteria, included other types of perinatal complications and other conditions that were unrelated to the population of pregnant mothers. Outcome of the search: The systematic search was conducted via relevant databases obtained from the Hybrid Database provided by the University of Malta which yielded one systematic review and meta-analysis, one randomized control trial, one retrospective cohort and three prospective cohort study. Methods of appraisal: The critical appraisal was performed by means of Critical Appraisal Skills Programme (CASP) tool. Main results of evidence: All seven articles were analysed. These studies found that maternal asthma was related with an increased risk of preterm birth. In some articles, other factors such as asthma treatment, poor asthma control and asthma exacerbation were related with the increased risk of preterm birth. Main conclusion: Evidence of these seven articles gathered was not highly conclusive; however, they indicated possible benefits, foremost of which is that maternal asthma during pregnancy can increase preterm birth. Also, other adverse effects of asthma in pregnant women was shown. Implication and recommendation: It is recommended that pregnant mothers, who suffer from asthma be encouraged to have active management of their condition to avoid preterm birth. It is essential to educate pregnant mothers or those women who are planning to get pregnant and convince them of the importance of being in control of their asthmatic condition. More emphasis should be laid on educating the general public to ensure healthy pregnancy and a healthy foetus. The need for further research and the selection of a larger population would ensure more reliable results, and wider generalizability of outcomes, and help to achieve evidence-based practice.