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Adverse Maternal Outcomes among Asthma Women. Jay J. Shen, Ph.D. Nancy MacMullen, Ph.D. Catherine Tymkow, N.D. Governors State University This study was, in part, supported by Agency for Healthcare Research and Quality. Background.
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Adverse Maternal Outcomes among Asthma Women Jay J. Shen, Ph.D. Nancy MacMullen, Ph.D. Catherine Tymkow, N.D. Governors State University This study was, in part, supported by Agency for Healthcare Research and Quality.
Background • Asthma is a chronic disease caused by airway inflammation and airway obstruction • The prevalence of asthma is on the increase • In 1994, 13.7 million people in the U.S. were diagnosed with asthma or asthma related conditions (CDC) • In 1998, 17.3 million in the U.S. had asthma or asthma related conditions (American Lung Association) • Limited research has been done on adverse maternal outcomes of asthmatic women who are more susceptible to poorer outcomes.
Objective • To examine differences in adverse maternal outcomes between women with asthma and women without asthma.
Methods (Data) • 7,777 asthmatic patients identified from 563,621 women aged from 13 to 55 who had a delivery in 2001, abstracted from the National Inpatient Sample. • 31,108 (four times of 7,777) patients were randomly selected from 541,719 non-asthmatic women as the comparison group of the asthmatic patients.
Methods (Measures) • Twelve adverse maternal outcome measures • Pre-term labor (22-37 weeks of gestation) • Hypertensive disorders of pregnancy (3 measures) • Gestational diabetes • Antepartum hemorrhage (2 measures) • Membrane disorders (2 measures) • Cesarean section • Postpartum hemorrhage • Pregnancy longer than 42 weeks • Maternal age, ethnicity, health insurance status, the income level and comorbidities were controlled.
Results • 1.4 % of the women who delivered had asthma in 2001. • Average age at delivery: • Women with asthma: 27.0 years old. • Women without asthma: 27.4 years old. • Average length of stay • Women with asthma: 3.0 days. • Women without asthma: 2.5 days.
Conclusion • In comparing adverse maternal outcomes of non-asthmatic women, asthmatic women had poorer outcomes in all of the 12 measures. • Asthmatic women were clinically much more vulnerable to having adverse maternal outcomes.
Policy Implications • Health care providers should be aware of adverse pregnancy outcomes resulting from etiological factors related to asthma. • Preventive interventions such as educational programs, symptom and medication management, and avoidance of environmental and stress related triggers will assist women to co-manage their asthma during pregnancy.