Asthma test in pregnancy cuts low birthweight risk

Adjusting asthma therapy in pregnancy in response to a direct measurement of airway inflammation can cut exacerbations that cause low birthweight, research suggests.

Treat asthma to cut the risk to the fetus (Photograph: SPL)
Treat asthma to cut the risk to the fetus (Photograph: SPL)

Researchers in Australia found this could halve the number of asthma exacerbations in pregnant women. Asthma can cause low birthweight in babies and maternal distress, the researchers said.

The method was developed by a team at the University of Newcastle in New South Wales. It involves testing for exhaled nitric oxide, a marker for airway inflammation. Clinicians then modify dosage of inhaled corticosteroids and beta-2 agonist doses.

The researchers randomly assigned 220 pregnant women with asthma to be managed by the algorithm or by a control method that uses clinical symptoms to adjust dosing. Women managed by the new system experienced an average 0.29 exacerbations per pregnancy, compared with 0.62 in the control group. Treating just six pregnant women using the new system would prevent one woman from having an exacerbation.

Although 26% more women received inhaled corticosteroids as a result of the method, it led to more frequent but lower overall doses than the control group. It also reduced the use of beta-2 agonists.

Researchers concluded: 'This approach might also be beneficial for non-pregnant women with asthma.'

Stephen Robinson

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The Lancet

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