Effects of mild to moderate asthma in pregnancy on the wellbeing of mother and newborn; A case control study from Sri Lanka

Background: Severe bronchial asthma (BA) in pregnancy is known to adversely affect its outcome, however, effects of mild-moderate BA in pregnancy is less studied. We aimed to study the maternal and newborn health effects related to mild-moderate BA in pregnancy, at a tertiary care hospital in Sri Lanka. Methodology: Among 539 pregnant mothers presented during July 2019 to March 2020 to Teaching Hospital Peradeniya, 38 had mild-moderate BA in mid-pregnancy (Group 1/G1). 28 had pre-pregnant BA, but remained asymptomatic during pregnancy (Group 2/G2). We followed up 30 of G1 and 22 of G2 with telephone interviews at average 08 months after delivery. We selected 52 age and parity matched non-asthmatic controls. Fisher’s exact test, followed by Mantel-Haenszel trend analysis were used for categorical variables. Birth weight was analysed using linear trend for ANOVA. Results: All in G1 responded well to steroid inhalers. 20%(6), 9%(2) and 2%(1) in G1, G2 and controls respectively required nebulizing during delivery due to symptomatic wheeze (p=0.014; p value for trend 0.007). 40%(12) in G1, 5%(1) in G2 and none among controls developed symptomatic wheezing in puerperium (pl0.001; p for trend l0.001). Birth weights of babies were 2.8±0.6, 3.0±0.4, 3.0±0.4 kg among G1, G2 and controls (F=2.235, p=0.112; p for trend 0.101). Among babies born to G1, G2 and control mothers, 10%(3), 5%(1) and none respectively had audible wheezing in early life (p=0.056; p for trend 0.026). Conclusion: Mild-moderate BA was seen in 7.1% of this unselected group of pregnant mothers. This has adversely affected mothers during delivery and puerperium and makes newborns at risk of developing wheezing in early life.