title: Effect of gestational age and position on peak expiratory flow rate: a longitudinal study.
abstract: OBJECTIVE
  We sought to study the effects of gestational age and maternal position on peak expiratory flow rates.
  
  
  METHODS
  Peak expiratory flow rates were measured in the standing, sitting, and supine positions in 38 healthy pregnant women at 4-week intervals starting at less than 10 weeks until delivery and again at 6 weeks postpartum. The highest reading of 3 consecutive peak expiratory flow rate measurements for each encounter and position was used in the analysis. Repeated measures analysis of covariance was performed with subjects, gestational age, position, and gestational age times position as the model effects. Least squares mean peak expiratory flow rates were compared among positions at different gestation ages using Bonferroni-adjusted least significant difference t tests.
  
  
  RESULTS
  Peak expiratory flow rate declined significantly throughout gestation in all positions (P < .001) with mean rate of decline of 0.65 L/min per week). The slopes of linear trends were not statistically different between positions (P = .222). However, the rate of decline for the supine position was higher than for standing and sitting positions (0.86 compared with 0.46 and 0.57 L/min per week), respectively. On average, the postpartum peak expiratory flow rate returned to 71.9% of its measurement in early gestation. Nomograms depicting mean and the 5th and 95th percentiles of peak expiratory flow rates were constructed for each position.
  
  
  CONCLUSIONS
  Peak expiratory flow rate measurements are affected by maternal position and advancing gestational age, especially in the supine position. Adjustment of patient's flow rate in relation to gestational age and maternal position is recommended, especially in pregnant women with asthma.
  
  
  METHODS
  III.
authors.affiliation: University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-0587, USA. hmharira@utmb.edu
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Harirah
authors.forename: Sahar E
authors.initials: SE
authors.lastname: Donia
authors.forename: Fayez K
authors.initials: FK
authors.lastname: Nasrallah
authors.forename: George R
authors.initials: GR
authors.lastname: Saade
authors.forename: Michael A
authors.initials: MA
authors.lastname: Belfort
mesh_terms: D000328:Adult; D000886:Anthropometry; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008137:Longitudinal Studies; D008423:Maternal Age; D010366:Peak Expiratory Flow Rate; D011187:Posture / Q000502:physiology*; D011247:Pregnancy / Q000502:physiology*; D011336:Probability; D011659:Pulmonary Gas Exchange; D012016:Reference Values; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012494:Sampling Studies