Asthma in a prospective cohort of rural pregnant women from Sri Lanka: Need for better care during the pre-conceptional and antenatal period

• Published in: PloS one Vol. 17; no. 7; p. e0269888
• Main Authors: Rajapakse, Shashanka, Wickramasinghe, Nuwan, Warnasekara, Janith, Abeyrathna, Parami, Amarasinghe, Gayani, Hettiarachchi, Ayesh Umeshana, Jayasinghe, Imasha Upulini, Koralegedara, Iresha, Agampodi, Thilini Chanchala, Agampodi, Suneth B
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 14.07.2022; Public Library of Science (PLoS)
• Subjects: Asthma; Birth weight; Care and treatment; Comorbidity; Confidence intervals; Consent; Diagnosis; Dyspnea; Epidemiology; Geography; Health aspects; Health risks; Health services; Low birth weight; Medicine and Health Sciences; Patient education; People and places; Pregnancy; Pregnant women; Private sector; Womens health; Sri Lanka
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0269888

To describe the epidemiology and the effect of asthma on pregnancy outcomes in pregnant women from a rural geography. We conducted a prospective cohort study in Anuradhapura district, Sri Lanka enrolling all eligible pregnant women registered in the maternal care program. An interviewer-administered questionnaire-based symptom analysis and clinical assessment was conducted in the first and second trimesters. We recruited 3374 pregnant women aged 15-48 years at conception. Self-reported physician-diagnosed asthma prevalence was 6.6% (n = 223) with only 41.7% (n = 93) on regular medical follow-up for asthma. The prevalence of wheeze reduced from pre-pregnancy (67.0%) to the first (46.4%) and second trimesters (47.7%; p<0.01). Of the 73 asthmatic women who did not have wheeze in the last 3 months preceding pregnancy, new-onset wheeze was reported by 6(8.2%) and 12(16.4%) in the first and second trimester, respectively. Pregnant women who sought medical care for asthma in the private sector had a lower likelihood of developing new-onset wheeze in the first trimester (p = 0.03; unadjusted OR = 0.94;95%CI 0.89-0.99). Thirty-four (33.3%) pregnant women had at least one hospital admission due to exacerbation of wheeze during the first and second trimester. The prevalence of low birth weight (16.0%) was higher among pregnant asthmatic women. This study reports the high prevalence of asthma and asthma-associated pregnancy outcomes in women from a rural geography signifying the importance of targeted management.