哮喘联盟

   摘要
   背景：呼吸道病毒性感染在妊娠期十分普遍，但其对健康的影响，尤其是对哮喘患者的健康影响尚未可知。本研究目的旨在评估伴有和不伴哮喘女性在妊娠期内呼吸道病毒感染的发生频率、严重程度和预后。
   方法：该项前瞻性队列研究采用普通感冒调查问卷和自我报告方式检查普通感冒症状。妊娠期出现普通感冒症状的哮喘妇女为168例，非哮喘妇女为117例。对疑似感染者收集其鼻和咽喉拭子，并进行聚合酶链反应检测呼吸道病毒。记录妊娠和哮喘结果。
   结果：通过自我报告和问卷评估，哮喘孕妇检查出普通感冒的可能性高于无哮喘的孕妇（发生率比1.77, 95%CI [1.30, 2.42]）。回顾性报道结果显示，在妊娠早期和产后普通感冒发生率哮喘孕妇高于无哮喘孕妇，且感冒症状也更为严重（感冒总评分中位值[四分位间距]：哮喘孕妇8[5, 10] vs 对照组6 [5, 8]，P=0.031）。对于实验室确诊为病毒感染的哮喘孕妇，其母亲健康情况更差，其中60%的感染与哮喘未控制相关，并具有更高的先兆子痫风险。
   结论：伴有哮喘的孕妇比不伴哮喘者更常发生普通感冒。妊娠期间感冒通常导致母亲和妊娠的不良预后。预防妊娠期病毒感染有助于改善哮喘母亲的健康状况。
 

(林江涛 审校)
Chest. 2013 Mar 14. doi: 10.1378/chest.12-1956. [Epub ahead of print]

 

a prospective study of respiratory viral infection in pregnant women with and without asthma.

Murphy VE, Powell H, Wark PA, Gibson PG.

ABSTRACT
BACKGROUND:Respiratory viral infections are common in pregnancy, but their health impact, especially in asthma is unknown. The objective of the study was to assess the frequency, severity and consequences of respiratory viral infection in pregnancy in women with and without asthma.
METHODS:In this prospective cohort study, common cold symptoms were assessed during pregnancy in 168 women with asthma, and 117 women without asthma, using the common cold questionnaire and by self-report. Nasal and throat swabs were collected for suspected infections and tested by polymerase chain reaction for respiratory viruses. Pregnancy and asthma outcomes were recorded.
RESULTS:Pregnant women with asthma had more prospective self-reported and questionnaire detected common colds than pregnant women without asthma ( incidence rate ratio 1.77, 95% confidence interval [1.30, 2.42], P<0.0001). Retrospectively reported common colds in early pregnancy and postpartum were increased in asthma compared to women without asthma. The severity of cold symptoms was also increased in asthma (total cold score median 8 interquartile range [5, 10] in asthma, vs 6 [5, 8] in controls, P=0.031). Among women with asthma, having a laboratory confirmed viral infection was associated with poorer maternal health, with 60% of infections associated with uncontrolled asthma and a higher likelihood of pre-eclampsia.
CONCLUSIONS:Pregnant women with asthma have more common colds during pregnancy than pregnant women without asthma. Colds during pregnancy were associated with adverse maternal and pregnancy outcomes. Prevention of viral infection in pregnancy may improve the health of mothers with asthma.
 

Chest. 2013 Mar 14. doi: 10.1378/chest.12-1956. [Epub ahead of print]