Evidence map›Paper›PMID 40876965›Full record

ArticleThe European respiratory journal2025

Pregnancy, asthma and exacerbations: a population-based cohort.

Bohee Lee, Ernie Wong, Tricia Tan, Hitasha Rupani, Chloe I Bloom

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Article in The European respiratory journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Bohee LeeNational Heart and Lung Institute, Imperial College London, London, UK.ORCID https://orcid.org/0000-0002-9671-386X
Ernie WongNational Heart and Lung Institute, Imperial College London, London, UK.
Tricia TanDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
Hitasha RupaniDepartment of Respiratory Medicine, University Hospitals Southampton NHS Foundation Trust, Southampton, UK.ORCID https://orcid.org/0000-0002-0150-138X
Chloe I BloomNational Heart and Lung Institute, Imperial College London, London, UK chloe.bloom06@imperial.ac.uk.ORCID https://orcid.org/0000-0003-1285-7602

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAsthma exacerbations during pregnancy are associated with adverse maternal and perinatal outcomes. Identifying modifiable risk factors is essential for improving health outcomes. We aimed to describe exacerbation patterns during pregnancy and identify exacerbation risk factors, particularly modifiable risk factors such as inhaled corticosteroid use.

methodsThis was a cohort study using UK primary care and hospital data (2004-2020) to identify pregnant women with asthma. Exacerbations were defined as a short course of oral corticosteroids, emergency department visit or unscheduled hospital admission. Multivariable logistic regression was used to assess associations between maternal characteristics and exacerbations (primary outcome) and inhaled corticosteroid use (secondary outcome).

resultsAmong 40 196 pregnant women with asthma, total exacerbations declined by ∼30% during pregnancy. However, exacerbations associated with hospital admission increased by 30-45% during the second and third trimesters, declining abruptly after delivery. Inhaled corticosteroid prescriptions were reduced in 31% of women during pregnancy. Decreased inhaled corticosteroid use was associated with suboptimal asthma control pre-pregnancy, age, ethnicity and smoking. The strongest exacerbation risk factors were a history of exacerbations (adjusted OR 4.09, 95% CI 3.81-4.39), reduced inhaled corticosteroid use during pregnancy (adjusted OR 2.29, 95% CI 2.12-2.47) and ≥4 prescriptions per year for inhaled corticosteroids plus another preventer before pregnancy (adjusted odds ratio 2.11, 95% CI 1.87-2.37). Additional risk factors included blood eosinophilia, smoking and obesity.

conclusionsDespite fewer total exacerbations, exacerbations associated with a hospital admission increased during pregnancy. One third of women reduced inhaled corticosteroid use during pregnancy, yet this was the second largest exacerbation risk factor and is completely modifiable. Other major risk factors were type 2 inflammation and another modifiable risk factor, suboptimal asthma control pre-pregnancy.

Indexed as

Adrenal Cortex HormonesAnti-Asthmatic AgentsAsthmaPregnancy ComplicationsAdministration, InhalationAdultCohort StudiesDisease ProgressionFemaleHospitalizationHumansLogistic ModelsPregnancyRisk FactorsUnited KingdomYoung AdultAdrenal Cortex HormonesAnti-Asthmatic Agents

Identifiers

PMID40876965
PMCPMC12713386

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.