This report outlines a proposed approach to monitoring asthma during pregnancy by capitalising on existing data sources as well as identifying data development opportunities.
Pregnant women with poorly controlled asthma are at increased risk of experiencing pregnancy-induced hypertension and pre-eclampsia. They are also at increased risk of having infants that are premature or small for their gestational age.
Clinical guidelines emphasise the importance of pregnant women with asthma using their asthma medications as prescribed. Taking prescribed preventer medicines for asthma is safer for pregnant women and their infants than having uncontrolled asthma.
Asthma can be controlled, and exacerbations of asthma can be prevented, with good care during pregnancy. If asthma control is maintained during pregnancy, the outcomes for the woman and infant are no different than for women who do not have asthma.
Currently, in Australia, there is no nationally consistent collection of asthma-management data in pregnant women. Improved information about management practices among pregnant women with asthma would enable us to:
- ascertain who is getting good care for asthma during pregnancy
- identify opportunities for improving care for pregnant women with asthma.
This report recommends the following indicators of good care for asthma during pregnancy:
- proportion of pregnant women who have their asthma status documented
- proportion of pregnant women with asthma who had a review of their asthma during the first trimester
- proportion of pregnant women with asthma who have a 4- to 6-weekly review of their asthma during pregnancy.
Improving data on the management of asthma during pregnancy could be achieved by:
- augmenting existing national perinatal data
- enhancing general practice data
- conducting periodic surveys in the antenatal setting.
The problems and solutions that have been identified for asthma may have analogous application in relation to other common chronic diseases that require management during pregnancy, such as diabetes and epilepsy.
Authored by Guy Marks, Helen Reddel, Elyse Guevara-Rattray and Rosario Ampon of the Australian Centre for Asthma Monitoring (ACAM).