Evidence map›Paper›PMID 37216974›Full record

ArticleAmerican journal of perinatology2024

The Association of Periconception Asthma Medication Discontinuation with Adverse Obstetric Outcomes.

Matthew C H Rohn, Danielle R Stevens, William A Grobman, Rajesh Kumar, Zhen Chen, Jessy Deshane, Joseph R Biggio, Akila Subramaniam, Katherine L Grantz, Seth Sherman and 1 more

Open access · greenAbstract read
In one paragraph

Article in American journal of perinatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Matthew C H RohnDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.ORCID 0000-0002-0892-6970
Danielle R StevensDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
William A GrobmanNorthwestern University Feinberg School of Medicine, Chicago, Illinois.
Rajesh KumarNorthwestern University Feinberg School of Medicine, Chicago, Illinois.
Zhen ChenDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Jessy DeshaneThe University of Alabama at Birmingham, Birmingham, Alabama.
Joseph R BiggioThe University of Alabama at Birmingham, Birmingham, Alabama.
Akila SubramaniamThe University of Alabama at Birmingham, Birmingham, Alabama.
Katherine L GrantzDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Seth ShermanThe Emmes Company, Rockville, Maryland.
Pauline MendolaDivision of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
National Institutes of Health · USNorthwestern University · USUniversity of Alabama at Birmingham · USEmmes (United States) · USGeorge Washington University Hospital · USOchsner Health System · US

Funding

NICHD NIH HHS HHSN275201300013CNICHD NIH HHS HHSN275201300014CNICHD NIH HHS HHSN275201300026IUniversity of Alabama at Birmingham, and the Emmes Company for the Data Coordinating Center HHSN27500001University of Alabama at Birmingham, and the Emmes Company for the Data Coordinating Center HHSN275000017
6 · The paper itself

Abstract

objectiveThis study aimed to investigate asthma medication reduction in the periconceptional period as it relates to asthma status and adverse outcomes in pregnancy. STUDY

designIn a prospective cohort study, self-reported current and past asthma medications were collected and analyzes compared measures of asthma status in women who discontinued asthma medication in the 6 months prior to enrollment ("step-down") versus those who did not ("no change"). Evaluation of asthma was done at three study visits (one per trimester) and by daily diaries, including measures of lung function (percent predicted forced expiratory volume in 1 and 6 s [%FEV1, %FEV6], peak expiratory flow [%PEF], forced vital capacity [%FVC], FEV1 to FVC ratio [FEV1/FVC]), lung inflammation (fractional exhaled nitric oxide [FeNO], ppb), rate of asthma symptoms (activity limitation, night symptoms, rescue inhaler use, wheeze, shortness of breath, cough, chest tightness, chest pain), and rate of asthma exacerbations. Adverse pregnancy outcomes were also evaluated. Adjusted regression analyses examined whether adverse outcomes differed by periconceptional asthma medication changes.

resultsOf 279 participants included in analyses, 135 (48.4%) did not change asthma medication in the periconceptional period, whereas 144 (51.6%) reported a step down in medication. Those in the step-down group were more likely to have milder disease (88 [61.1%] in the step-down vs. 74 [54.8%] in the no change group), exhibited less activity limitation (rate ratio [RR]: 0.68, 95% confidence interval [CI]: 0.47-0.98), and experienced fewer asthma attacks (RR: 0.53, 95% CI: 0.34-0.84) during pregnancy. The step-down group had a nonsignificant increase in overall odds of experiencing an adverse pregnancy outcome (odds ratio: 1.62, 95% CI: 0.97-2.72).

conclusionOver half of women with asthma reduce asthma medication in the periconceptional period. Although these women typically have milder disease, a step down in medication may be associated with an increased risk of adverse pregnancy outcomes. KEY POINTS: · Many women reduce their asthma medication in pregnancy.. · Reduction is more common among those with mild disease.. · Medication reduction may lead to adverse pregnancy outcomes..

Indexed as

Anti-Asthmatic AgentsAsthmaPregnancy ComplicationsAdultFemaleForced Expiratory VolumeHumansPregnancyPregnancy OutcomeProspective StudiesRespiratory Function TestsVital CapacityYoung AdultAnti-Asthmatic Agents

Identifiers

PMID37216974
PMCPMC12212745
OpenAlexW4377233322

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.