A Compounding Challenge: An Evidence-Based Case Report on the Link Between Obesity and Asthma Exacerbations in Pregnancy

Abstract

Background: Asthma exacerbations in pregnancy have been found to increase risk of adverse perinatal outcomes. Obesity during pregnancy, a condition of rising prevalence, is hypothesized to worsen asthma control through inflammatory mechanisms. However, the scientific evidence on the association between the two variables remains contradictory. This Evidence-Based Case Report aims to determine the association between early-pregnancy obesity and asthma exacerbation during pregnancy by synthesizing findings from various related studies.

Methods: A literature search was conducted using relevant keywords from utilized databases: PubMed, ScienceDirect, Cochrane, and ClinicalTrials.gov. The Oxford Centre for Evidence-Based Medicine (CEBM) framework was used to appraise the literature that met the inclusion and exclusion criteria.

Results: This review identified five studies, comprising one systematic review and meta-analysis and four cohort studies. These studies were appraised as valid, important, and applicable. Four of the five studies reported significant increased risk of asthma exacerbation in pregnant women with early-pregnancy obesity. The study by Stevens et al. (2022) reported a decreased risk of exacerbation in pregnant women with obesity compared to the control group, attributing this to differences in perception thresholds between the groups and the possibility of study bias.

Conclusion: Pregnant women with obesity in early pregnancy have a higher risk of experiencing asthma exacerbations during pregnancy compared to non-obese groups. Therefore, this condition requires enhanced monitoring and asthma management to prevent maternal and perinatal complications.