Asthma affects fertility treatment in women, prolongs time to pregnancy, and lowers birth rate, according to research. Until now, the association between asthma and fertility has yielded conflicting results, but the latest studies used more in-depth testing for the investigation.
For the current study, researchers looked at 245 women aged 23 to 45 with unexplained fertility problems. The women underwent asthma and allergy testing, and had to complete questionnaires during their fertility treatment. Ninety-six women had either an existing diagnosis of asthma or were diagnosed with asthma upon entering the study.
The researchers monitored the women during their fertility treatment for at least 12 months, until they achieved a successful conception, stopped treatment or the observation ended.
Median total time to achieve pregnancy was 32.2 months in non-asthmatic women and 55.6 months in asthmatic women. Asthmatics also had fewer successful conceptions – 39.6 percent – compared to 60.4 percent of non-asthmatic women.
Lead author Dr. Elisabeth Juul Gade said, “This finding in a clinical trial setting adds new weight to the epidemiological evidence suggesting a link between asthma and fertility. We have seen here that asthma seems to have a negative influence on fertility as it increases time to pregnancy and even more so with age. We do not yet know the causal relationship. It may be complex with different types of asthma, psychological wellbeing, asthma medication, and hormones all play a role. Given this new evidence, we believe that clinicians should encourage women with asthma to become pregnant at an earlier age and optimize their treatment for asthma preconception. Patient education is also of paramount importance as adherence to treatment may be enhanced if patients are informed of this link.”
An earlier study found that proper asthma management during pregnancy is vital, as poor asthma control can have adverse effects on maternal and fetal outcomes. The review noted that severity of asthma during pregnancy stays unchanged, worsens, or improves in equal proportions. The asthma control is more likely to deteriorate during pregnancy in women with severe condition, compared to patients with mild asthma. The authors did note that all pregnant asthmatic women need to be carefully monitored during their pregnancy term, regardless of the severity degree of their asthma.
Asthma control for pregnant women can be the same as in non-pregnant women, but with a stronger focus on monitoring the fetus depending on asthma severity.
Previous studies have linked poor asthma control during pregnancy with hypertension, higher rate of C-section delivery, and low birth weight. If pregnant women properly control their asthma, these adverse effects can be significantly reduced.
Coauthor of the study, professor Chris Brightling said, “Asthma is a widespread condition and poor management during pregnancy can lead to adverse maternal and fetal outcomes. Good asthma management to maintain tight control is vital and standard therapy may be safely used in pregnancy to achieve this along with close surveillance from midwives, obstetricians, and – for women with severe asthma – a respiratory physician.”
Jason Waugh, editor-in-chief of The Obstetrician & Gynaecologist (TOG), concluded, “Education is key for anyone, especially pregnant women, to manage their asthma. This includes understanding the condition and its treatment options, trigger avoidance, asthma control, adequate use of devices, and the importance of adherence to medication. Any women who have concerns about their asthma management and management during pregnancy should contact their GP or midwife for further advice.”
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