Tuesday, May 5, 2009

Pregnancy and asthma

I'd like to highlight an article by Valet, Dupont, Mitchel, and Hartert in the Annals of Allergy April 2009 issue (102: 352-3.) on pregnancy and asthma. This is the first graphical representation I have ever read that demonstrates what asthma specialists have known by observation for many years.
The top graphs show the percent change in rescue beta agonist use compared to prior to pregnancy. Top left is for whites and top right is for blacks. Asthma specialists cite the rule of thirds: 1/3 get better, 1/3 get worse, and 1/3 stay the same. Their data supports this.
The graph in the middle shows the change in rescue beta agonist use compared to number of weeks pregnant, for both whites and blacks. There is an improvement from weeks 10-20 and a worsening from weeks 25-30. So where a woman is at during her pregnancy matters.
The bottom graph shows the same information: with data for white in the blue line and data for blacks in the red line. Both group experience fluctuations in asthma over time. The white group (blue line) shows decreases, that is below the zero line. The black group (red line) shows an often significantly worse need for rescue inhalers by the 10th week and for most of the rest of the pregnancy. By week 17, their asthma is often worse than at baseline. The reasons for the difference between these two races is unclear. This data showed asthmatic, pregnant, black women and their health care providers should be especially careful with controlling the asthma.
If you have questions, ask your asthma doctor....

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