Asthma Control During Pregnancy and Adverse Perinatal Outcomes: A Systematic Review

BACKGROUND AND AIM: Poor control of maternal asthma during pregnancy may increase the risk of pregnancy complications and adverse perinatal outcomes. The present review provides an update on the current knowledge of the association between asthma control during pregnancy and pregnancy complications, which are pre-eclampsia, low birth weight (LBW), pre-term birth, and small for gestational age (SGA). METHODS: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 14 studies fulfilled the predefined criteria for inclusion in the present review. The included studies revealed that the presence of maternal asthma per se is associated with an increased risk of SGA, whereas the observations were contradictory in relation to pre-eclampsia, LBW and pre-term birth. Asthma exacerbations and uncontrolled asthma during pregnancy were associated with an increased risk of pre-eclampsia. The studies did, however, not consistently suggest an increased risk of LBW, pre-term birth or SGA associated with asthma exacerbations during pregnancy. CONCLUSIONS: Apart from small for gestational age, maternal asthma itself is not associated with a higher risk of pregnancy complications and adverse perinatal outcomes. However, asthma exacerbations and uncontrolled asthma during pregnancy increase the risk of pre-eclampsia.