Email this article Possibilities for predicting preeclampsia development in pregnant women with bronchial asthma
- Authors: Lavrova O.V.1, Kulikov V.D.1, Shapovalova E.A.2, Sablina A.V.3
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Affiliations:
- Academician I.P. Pavlov First Saint Petersburg State Medical University, the Research Institute of Pulmonology
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- Children’s City Polyclinic No. 68, Women’s Consultation No. 8
- Issue: Vol 68, No 4 (2019)
- Pages: 13-18
- Section: Original study articles
- URL: https://journals.rcsi.science/jowd/article/view/11276
- DOI: https://doi.org/10.17816/JOWD68413-18
- ID: 11276
Cite item
Abstract
Hypothesis/aims of study. Currently, preeclampsia is one of the most pressing problems of obstetrics due to the complexity of pathogenesis and to the lack of early and reliable diagnostic criteria. The preeclampsia rate in patients with bronchial asthma is proved higher than in asthma free pregnant women. This study aimed to establish the prediction algorithm of preeclampsia development in in pregnant women suffering from bronchial asthma of varying severity and different level of control.
Study design, materials and methods. Asthma duration was studied in 110 pregnant women using the SPSS Discriminant Function Analysis method. Basic therapy and level of asthma control were studied together with respiratory tests, obstetrician medical history, and complications of the first and second trimesters of pregnancy. In addition, serum interleukin panel was assessed and placental Doppler measurement was carried out.
Results. Clinical and statistical analysis made it possible out of 87 significant risk factors for the development of hypertensive disorders and preeclampsia to form a highly informative set of signs for a linear discriminant model for predicting preeclampsia: 1) asthma exacerbation in the first trimester of pregnancy; 2) asthma duration severity; 3) average dose of inhaled glucocorticosteroid drugs administered to the exact patient during pregnancy; 4) serum levels of tumor necrosis factor, interferon gamma, and interleukins-4, 6, and 8.
Conclusion. The inclusion method of step-by-step discriminant analysis allowed establishing a highly informative four-component complex of clinical predictors for preeclampsia development in pregnant women with asthma. The results of the model testing showed its extremely high reliability (up to 100% within study selection as well as within control selection). Thus, the study results can be recommended for clinical use.
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##article.viewOnOriginalSite##About the authors
Olga V. Lavrova
Academician I.P. Pavlov First Saint Petersburg State Medical University, the Research Institute of Pulmonology
Author for correspondence.
Email: loverova@bk.ru
MD, PhD, DSci (Medicine), Leading Researcher. The Laboratory of Hereditary Mechanisms of Lung Diseases, the Research Institute of Pulmonology
Russian Federation, Saint PetersburgValery D. Kulikov
Academician I.P. Pavlov First Saint Petersburg State Medical University, the Research Institute of Pulmonology
Email: vdkulikov@mail.ru
MD, PhD, Leading Researcher. The Department of Social and Ecological Pulmonology, the Research Institute of Pulmonology
Russian Federation, Saint PetersburgElena A. Shapovalova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
Email: e.shapovalova@mail.ru
MD, PhD, Senior Researcher. The Department of Pregnancy Pathology I
Russian Federation, Saint PetersburgAnna V. Sablina
Children’s City Polyclinic No. 68, Women’s Consultation No. 8
Email: anna_s-piter@mail.ru
MD
Russian Federation, Saint PetersburgReferences
- Vatti RR, Teuber SS. Asthma and pregnancy. Clin Rev Allergy Immunol. 2012;43(1-2):45-56. https://doi.org/10.1007/s12016-011-8277-8.
- Kelly W, Massoumi A, Lazarus A. Asthma in pregnancy: Physiology, diagnosis, and management. Postgrad Med. 2015;127(4):349-358. https://doi.org/10.1080/00325481. 2015.1016386.
- Schatz M, Zeiger RS. Improving asthma outcomes in large populations. J Allergy Clin Immunol. 2011;128(2):273-277. https://doi.org/10.1016/j.jaci.2011.03.027.
- Ali Z, Hansen AV, Ulrik CS. Exacerbations of asthma during pregnancy: Impact on pregnancy complications and outcome. J Obstet Gynaecol. 2016;36(4):455-461. https://doi.org/10.3109/01443615.2015.1065800.
- Murphy VE, Schatz M. Asthma in pregnancy: a hit for two. Eur Respir Rev. 2014;23(131):64-68. https://doi.org/10.1183/09059180.00008313.
- Cappelletti M, Giannelli S, Martinelli A, et al. Lack of activation of peripheral blood dendritic cells in human pregnancies complicated by intrauterine growth restriction. Placenta. 2013;34(1):35-41. https://doi.org/10.1016/j.placenta.2012. 10.016.
- Sircar M, Thadhani R, Karumanchi SA. Pathogenesis of preeclampsia. Curr Opin Nephrol Hypertens. 2015;24(2):131-138. https://doi.org/10.1097/MNH.0000000000000105.
- Phipps E, Prasanna D, Brima W, Jim B. Preeclampsia: updates in pathogenesis, definitions, and guidelines. Clin J Am Soc Nephrol. 2016;11(6):1102-1113. https://doi.org/10.2215/CJN.12081115.
- Mol BWJ, Roberts CT, Thangaratinam S, et al. Pre-eclampsia. Lancet. 2016;387(10022):999-1011. https://doi.org/ 10.1016/s0140-6736(15)00070-7.
- Esteve-Valverde E, Ferrer-Oliveras R, Gil-Aliberas N, et al. Pravastatin for preventing and treating preeclampsia: A systematic review. Obstet Gynecol Surv. 2018;73(1):40-55. https://doi.org/10.1097/OGX.0000000000000522.
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