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Asthma + Smoking Spells Birth Trouble

Mayo study shows babies at greater risk when pregnant asthmatics smoke

SATURDAY, May 5 (HealthScout) -- Women with asthma who smoke are twice as likely to have premature babies or babies with abnormalities than asthmatic women who don't smoke, a new Mayo Clinic report says.

Researchers reviewed obstetrical records of 702 women who gave birth at the Mayo Clinic in 1997 and 1998. The records were divided into four groups: Group A members had active asthma that required treatment; Group B had a history of asthma but no current symptoms and didn't need treatment; Group C had asthma symptoms but hadn't been diagnosed or treated; Group D members were non-asthmatic.

The four groups were compared by age, use of tobacco, alcohol and recreational drugs, duration of pregnancy, delivery type and "fetal outcomes," including birth weight, prematurity and abnormalities.

There were 86 premature babies and 74 birth abnormalities, which included cleft lip, club foot, hypoglycemia and respiratory distress syndrome.

The researchers found that 24 percent of the women who had active asthma and smoked had premature babies or ones with abnormalities, compared to 11 percent of the women with asthma who didn't smoke.

The study abstract was presented at the recent annual meeting of the American Academy of Allergy, Asthma and Immunology (AAAAI).

The fact that so many asthmatic women smoked while they were pregnant was a surprise, says the study's lead author, Kristin Kloos, a registered nurse and physician extender in the Mayo Clinic's division of allergic diseases.

"When we looked at alcohol and other drug use, there really wasn't a significant number and maybe the public has been educated more regarding fetal alcohol syndrome and those kind of things -- what alcohol can do to your fetus," Kloos says.

"I'm not sure if that message [about smoking] is coming out as clear as some of those others have come out."

Kloos says the incidence of smoking among asthmatic women who are pregnant is alarming, and they need to be aggressively counseled to stop smoking and be carefully supervised by their obstetricians and doctors who treat their asthma.

"They need to know what smoking can do if you are pregnant. And I think they need to know, if you are asthmatic and you smoke, this is what can happen if you combine all of that. You've just intensified all those possibilities for any kind of adverse reaction," Kloos adds.

As a follow-up to the study, Kloos plans to meet with members of the Mayo obstetrics department to discuss the study results and what can be done to help pregnant asthmatic women give up smoking.

"This is something we're going to continue to study. We will continue to look at the information from the data base so, hopefully, we can do some prospective study, working with the obstetrical department to see if we can improve the outcomes," Kloos says.

Prior data have suggested that women with asthma, particularly severe or poorly controlled asthma, may experience increased pregnancy complications, says Dr. Michael Schatz, chief of the department of allergy at the Kaiser-Permanente Medical Center in San Diego.

Also he says, although it's well-known that smoking increases the chances of pregnancy complications, the Mayo Clinic study confirms that the combination of the two is particularly dangerous.

He agrees that more needs to be done to educate asthmatic women about the dangers of smoking while they're pregnant.

What To Do

For more information about asthma, go to the American Academy of Allergy, Asthma and Immunology, or the American Lung Association.

Or you can read these HealthScout stories on asthma.

SOURCES: Interviews with Kristin Kloos, R.N., physician extender, division of allergic diseases, Mayo Clinic, Rochester, Minn.; Michael Schatz, M.D., chief, department of allergy, Kaiser-Permanente Medical Center, San Diego, Calif.
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