哮喘联盟

   摘要
   有证据表明，哮喘与女性生育能力关系密切。然而，目前的认识有限，且依据的是问卷调查性研究或者样本量很小。一项前瞻性、观察性队列研究，评估了伴或不伴哮喘的不明原因不孕女性在受孕所需时间(TTP)、不孕治疗的数量、成功受孕的数量方面是否有显著不同。245例不明原因不孕的女性（年龄23-45岁）进行不孕治疗的同时，接受问卷调查及哮喘和过敏原测试。最终纳入研究的96例女性，或既往被医生诊断为哮喘，或入组时被诊断为哮喘。入组后，对不孕治疗至少随访12个月，直至成功受孕、终止治疗或观察结束。哮喘女性受孕的几率低于无哮喘的女性：无哮喘女性的中位受孕所需时间为32.3个月，而哮喘女性为55.6个月，HR值为0.50 (95% CI: 0.34 - 0.74)，p < 0.001。不孕治疗中，哮喘女性成功受孕的几率低于无哮喘的女性，分别为39.6%和60.4% (p = 0.002)。年龄的增长延长了女性预期受孕所需时间，尤其是哮喘女性（年龄与哮喘相互作用对受孕所需时间的影响，p = 0.001）。哮喘女性比无哮喘女性受孕所需时间更长、受孕几率更低。年龄的增长降低了女性受孕几率，尤其是哮喘女性。然而，哮喘与生育力底下的因果关系尚不明确。

 

（杨冬 审校）
Eur Respir J. 2016 Feb 11. pii: ERJ-01389-2015. doi: 10.1183/13993003.01389-2015. [Epub ahead of print]

 

Fertility outcomes in asthma: a clinical study of 245 women with unexplained infertility.
 

Gade EJ1, Thomsen SF2, Lindenberg S3, Backer V4.
 

Abstract
Evidence is increasing of an association between asthma and aspects of female reproduction. However, current knowledge is limited and furthermore relies on questionnaire studies or small populations. In a prospective observational cohort study to investigate whether time to pregnancy, the number of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and withoutasthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96 women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.Thelikelihoodof achieving pregnancy was lower in women with asthma compared with those without asthma: median total time to pregnancy was 32.3 months in non-asthmatic women versus 55.6 months in those with asthma, hazard ratio 0.50 (95% confidence interval 0.34-0.74) p<0.001.Women with asthma had fewer successful pregnancies during fertility treatment, 39.6 versus 60.4% (p=0.002). Increasing age was of negative importance for expected time to pregnancy, especially among asthmatic women (interaction between age and asthma on time to pregnancy, p=0.001). Female asthmatics had a longer time to pregnancy and less often became pregnant than non-asthmatic women. Increasing age reduced the chances of conceiving especially among asthmatic women. The causal relationship between asthma and subfertility remains unclear.
 

Eur Respir J. 2016 Feb 11. pii: ERJ-01389-2015. doi: 10.1183/13993003.01389-2015. [Epub ahead of print]