GDM elevates risk of asthma exacerbations throughout pregnancy: Study

A new study published in The Journal of Allergy and Clinical Immunology; In Practice showed that gestational diabetes mellitus (GDM) raised the risk of asthma flare-ups throughout pregnancy by 36% in pregnant women with already present asthma. During pregnancy, up to 45% of pregnant women with asthma experience an asthma attack that necessitates medical attention. A higher risk of a number of unfavorable prenatal outcomes has been linked to both uncontrolled asthma and asthma flare-ups.

Exacerbations have also been linked to poor respiratory health, particularly asthma, in kids. Both gestational diabetes mellitus, which affects around 14% of pregnancies globally, and asthma, which affects about 13% of pregnancies, are linked to poor maternal and perinatal outcomes. Thereby, this study evaluated the relationship between GDM and pregnancy-related asthma. Additionally, to ascertain if a higher incidence of asthma flare-ups during pregnancy and the first year after giving birth is linked to GDM.

The electronic medical records of pregnant asthma patients from 2010 to 2023 were examined in this retrospective cohort research, which did not include individuals with co-occurring chronic lung illnesses or diabetes mellitus. The requirement for a prescription for an oral corticosteroid (OCS) was used to characterize asthma exacerbations. Adjustments for age, race, body mass index (BMI), history of pre-pregnancy asthma exacerbations, and insurance status were made using multivariable logistic regression and zero-inflated Poisson regression.

A total of 1492 out of 10985 people had GDM. And, these GDM patients had higher BMIs and were older. During pregnancy, but not after delivery, GDM was linked to a higher incidence of asthma exacerbations (adjusted OR 1.36, 95% CI 1.10-1.67).

Each doubling of blood glucose levels twice the risk of asthma exacerbations during pregnancy, according to stratified analyses of 4331 people having prenatal blood glucose measurements (adjusted OR of 2.02, 95% CI 1.45-2.81). Older age, Medicaid coverage, and pre-pregnancy asthma exacerbations were additional characteristics linked to asthma exacerbations.

The risk of exacerbations increased by double for every doubling of blood glucose levels. The increased risk was also influenced by other variables, such as older age and asthma flare-ups before pregnancy. Overall, pregnant women with pre-existing asthma should have early, universal screening and effective therapies to enhance blood glucose management, since the link between GDM and an increased risk of asthma exacerbations is clear.

Reference:

Zhang, P., Lappen, J. R., Attaway, A., Erzurum, S., Love, T. E., Zein, J., & Tsuang, W. (2024). Asthma Exacerbation Risk in Pregnancy and Postpartum: Assessing the Impact of Gestational Diabetes Mellitus and Other Key Factors. In The Journal of Allergy and Clinical Immunology: In Practice. Elsevier BV. https://doi.org/10.1016/j.jaip.2024.12.013