Dr Megan Jensen1,2, Dr Soriah Harvey1,2, Dr Jason Dizon3, Prof Elizabeth Holliday1,3, Dr Natasha Weaver1,3, Kimberley Barrass1, Ashley Colaco1, Jin Xiang Hong1, Katherine Leverett1, Dr Bronwyn Brew1,2, Prof Craig Pennell1, Prof Vanessa McDonald2,4, Prof Peterg Gibson1,2,5, A/Prof Vanessa Murphy1,2
1School of Medicine & Public Health, University of Newcastle, Newcastle, Australia, 2Asthma and Breathing Research Program, Hunter Medical Research Institute, Newcastle, Australia, 3Data Sciences, Hunter Medical Research Institute, Newcastle, Australia, 4School of Nursing and Midwifery, University of Newcastle, Newcastle , Australia, 5Department of Respiratory & Sleep Medicine, John Hunter Hospital, Newcastle, Australia
Biography:
Dr Jensen is an Advanced Accredited Practicing Dietitian and research fellow with the Asthma Breathing Program at Hunter Medical Research Institute/ University of Newcastle. Her research program on maternal and paediatric respiratory nutrition includes a Nutrition Program within a cohort of pregnant women with asthma and their offspring.
Abstract:
Background: Asthma and gestational diabetes mellitus (GDM) have each been independently associated with poor perinatal outcomes. Previous research has reported women with asthma are also at increased risk of GDM. However, no studies have determined whether perinatal outcomes are changed when women have both asthma and GDM.
Methods: Data were extracted from electronic obstetric records (e-Maternity) for pregnant women aged ≥18 years with singleton births who attended antenatal clinics in two local health districts in New South Wales, Australia, between 2018 and 2020. The risk of adverse perinatal outcomes, based on exposures of asthma and/or GDM were examined with multivariable regression.
Results: The analysis included 40,149 singleton pregnancies; 9.6% with asthma only, 9.6% with GDM only, and 1.4% with asthma+GDM. Asthma (vs neither exposure) was associated with several outcomes, including preterm birth (adjusted Relative Risk [aRR] 1.15, 95% confidence interval [CI] 1.04-1.13), low birthweight (aRR 1.18, 95% CI 1.04-1.33), caesarean birth (aRR 1.18, 95% CI 1.03-1.13), congenital anomaly (aRR 1.22 (95% CI 1.05-1.41)), and respiratory distress syndrome [RDS] (aRR 1.14 (95% CI 1.03-1.26). GDM (vs neither exposure) was associated with outcomes including RDS (aRR 1.24, 95% CI 1.13-1.36), hypertensive disorders of pregnancy [HDP] (aRR 1.34, 95% CI 1.19-1.51) and caesarean birth (aRR 1.16, 95% CI 1.11-1.21). The presence of both GDM and asthma (vs neither) was also associated with several outcomes, including RDS (aRR 1.42, 95% CI 1.16-1.75), caesarean birth (aRR 1.20, 95% CI 1.09-1.33) and HDP (aRR 1.36, 95%CI 1.05-1.77). However, no multiplicative interactions between asthma and GDM on outcomes were observed.
Conclusion: Asthma and GDM independently increased the risk of adverse perinatal outcomes in this contemporary sample of Australian pregnancies. Higher risk of some outcomes was also detected for pregnancies with both asthma and GDM, suggesting the presence of both conditions is associated with worse perinatal outcomes.
Keywords
asthma, diabetes, perinatal
References
Gang Wang, Vanessa E. Murphy, Jennifer Namazy, Heather Powell, Michael Schatz, Christina Chambers, John Attia & Peter G. Gibson (2014) The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis, The Journal of Maternal-Fetal & Neonatal Medicine, 27:9, 934-942, DOI: 10.3109/14767058.2013.847080