It is unknown how active asthma management influences symptom control among inner-city pregnant women who have unique exposures and socioeconomic limitations affecting their care.
To assess the impact of an integrated subspecialty intervention comprised of education and monitoring on asthma control among underserved women in an antenatal clinic setting.
We conducted a prospective cohort study of pregnant asthmatics participating in a subspecialty clinic integrated into routine prenatal care. We compared baseline characteristics and objective measurements of asthma control between women at an initial visit to those who were evaluated in at least one follow-up. For follow-up, we measured symptom control at successive visits and the incidence of asthma-related complications.
Among 85 women enrolled, 53 (62.4%) returned for at least one follow-up visit. Mean baseline ACT scores were similarly low (≤19) between the two groups (≥ 1 follow-up and no follow-up), as were MiniAQLQ scores (<4.7). Seventy-two (84.7%) women had inadequate asthma control resulting in step-up therapy after their initial visit. There was a significant increase in ACT scores between initial visit and first follow-up visit. For those with an intervening MiniAQLQ, there was also a significant increase by 1.39 ± 0.67 (p = 0.0003).
We found that uncontrolled asthma is common among urban women seeking routine obstetrical care. Our results suggest that even one interventional visit can result in significant improvement in asthma control. Further investigation into mechanisms for optimizing treatment strategies may improve the quality of asthma care during pregnancy in this underserved population.

Copyright © 2021. Published by Elsevier Inc.