哮喘联盟

   摘要
   目的：本试验旨在研究心理学指标、妊娠期哮喘发作风险和围产期转归的关系。
   方法：对在妊娠期哮喘女性中研究基于呼出气一氧化氮水平和以指南为基础调整哮喘治疗的随机、对照试验进行二级分析。妊娠12周至20周的女性入选本研究，并对随后的妊娠进行检测。采用控制哮喘感知问卷、简短疾病感知问卷、六项目简表状态特质焦虑量表对其进行心理社会问卷调查。哮喘发作定义为因为哮喘发作导致住院、急诊就诊、未预约的就诊和口服皮质激素治疗。围产期转归包括早产、小样儿和剖宫产。多因素回归分析对预测指标（人口统计学和心理社会和临床指标）进行分析。
   结果：175名参与者的平均年龄为28.5±5.4岁，FEV1%预测值为95.9±13.4，哮喘控制评分为0.88±0.70。对哮喘控制更好的感知能降低随后的哮喘发作（OR [95%CI] 0.92 [0.85, 0.98], p=0.016）、剖宫产（0.84 [0.75, 0.94], p=0.003）和早产（0.84 [0.72, 0.97], p=0.019）的优势比，但焦虑增加能增加随后哮喘发作的优势比（1.05 [1.01, 1.08], p=0.008）。
   结论：女性对哮喘控制的感知和其心理社会状态（焦虑）与未来哮喘发作风险、剖宫产和早产相关。
 

（苏楠 审校）
J Asthma. 2013 Jan 31. [Epub ahead of print]

 

Psychosocial Variables Are Related to Future Exacerbation Risk and Perinatal Outcomes in Pregnant Women with Asthma.
 
Powell H, McCaffery K, Murphy VE, Hensley MJ, Clifton VL, Giles W, Gibson PG.

Source
Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute , Newcastle, NSW , Australia.

Abstract 
OBJECTIVE：To determine the relationship between psychosocial variables, future exacerbation risk during pregnancy, and perinatal outcomes.
METHODS：A secondary analysis of a randomized controlled trial of exhaled nitric oxide versus guideline-based treatment adjustment in pregnant women with asthma. Women were recruited between 12 and 20 weeks gestation and monitored for the remainder of the pregnancy. Psychosocial questionnaires including the Perceived Control of Asthma Questionnaire, the Brief Illness Perception Questionnaire, and the Six-Item Short-Form State Trait Anxiety Inventory were assessed at randomization. Exacerbations were defined as hospitalization, emergency visit, unscheduled doctor visit, or oral corticosteroid use for worsening asthma. Perinatal outcomes included preterm birth, small for gestational age, and cesarean section. Multiple logistic regressions were performed with predictor variables, including demographics and psychosocial and clinical variables.
RESULTS：The 175 participants had a mean (SD) age = 28.5(5.4) years, forced expiratory volume in 1 second (FEV(1)%) predicted = 95.9(13.4), and asthma control score = 0.88(0.70). Greater perceived control of asthma reduced the odds of subsequent exacerbation (odds ratio (OR) [95%CI] 0.92 [0.85, 0.98], p = .016), cesarean without labor (0.84 [0.75, 0.94], p = .003), and preterm birth (0.84 [0.72, 0.97], p = .019), while increased anxiety increased the odds of subsequent exacerbation (1.05 [1.01, 1.08], p = .008).
CONCLUSION：Women's perceptions of asthma control and their psychosocial state (anxiety) are related to future exacerbation risk, cesarean section, and preterm birth.

J Asthma. 2013 Jan 31. [Epub ahead of print]