Psychosocial Outcomes Are Related to Asthma Control and Quality of Life in Pregnant Women with Asthma

Abstract

Background. Little is known about the psychosocial impact and perceived teratogenic (fetal harm due to medication) risks of asthma treatment (inhaled/oral corticosteroids and β-agonist) during pregnancy. Aims. To assess the perception of asthma control, quality of life (QoL), and perceived risks of therapy in pregnant women with asthma. Methods. Pregnant women with asthma (n = 125) were recruited between 12 and 20 weeks gestation. QoL (generic: Short Form-12 Health Survey v1, and asthma specific: Asthma Quality of Life Questionnaire-Marks (AQLQ-M)) and psychological variables were assessed using the Perceived Control of Asthma Questionnaire (PCAQ), the Brief Illness Perception Questionnaire, and the Six-Item Short-Form State Trait Anxiety Inventory (STAI-6). Women’s perceptions of the teratogenic risks of asthma therapy were also assessed and analyzed for adherence to maintenance inhaled corticosteroids (ICSs), poor asthma control, and QoL. Results. Women reported good QoL (median AQLQ-M total score/maximum score = 0.88/10), moderate ability to deal with asthma symptoms (mean PCAQ score = 42.6/55), positive beliefs about their asthma and low anxiety (median STAI score = 26.7/80). Perceived teratogenic risks for asthma drugs were excessive and class dependent. Women perceived there was a 42% teratogenic risk for oral corticosteroid, a 12% risk for ICSs, and a 5% risk with short-acting β-agonist. Illness beliefs, emotional response to illness (p = .030), age ≥ 30 years (p = .046), and maintenance ICS use (p = .045) were significantly associated with uncontrolled asthma, while maintenance ICS use (p = .023), illness beliefs, consequences (p = .044), timeline (p = .016), and emotional response (p = .015) and anxiety (p ≤ .0001) were significantly associated with reduced QoL. Conclusions. In pregnancy, women with asthma experience good QoL but overestimate teratogenic risks of asthma medication. Maintenance ICS use, illness beliefs, and anxiety are associated with impaired QoL and asthma control.

• asthma control
• illness beliefs
• perception
• quality of life
• teratogenic risk

Acknowledgments

This study was funded by National Health and Medical Research Council of Australia. Thanks to Prof D Robin Taylor for advice on study design; Kelly Steel, Karen McLaughlin, Rebecca Oldham, and Linda Howell for recruitment and clinical assessment; and Sandra Dowley for data entry.

Declaration of Interest

PGG has received payment for reimbursement of meeting/travel expenses from GlaxoSmithKline, AstraZeneca, Novartis, and BoerhingerIngelheim. MJH, KMcC, WG, HP, VLC, and VEM declare no conflict of interest.