title: Association of obesity with pulmonary and nonpulmonary complications of pregnancy in asthmatic women.
abstract: OBJECTIVE
  To evaluate whether maternal obesity is associated with pulmonary and nonpulmonary pregnancy complications in asthmatic women.
  
  
  METHODS
  This is a secondary analysis of the prospective cohort Asthma During Pregnancy Study. Asthma patients were classified as having either mild or moderate to severe disease at the beginning of the study. Rates of pulmonary complications of asthma in asthmatic women and rates of nonpulmonary complications of pregnancy among asthma patients and controls, were compared between obese (body mass index > or = 30 kg/m2) and nonobese women.
  
  
  RESULTS
  Maternal body mass index and pregnancy outcome data were available for 1,699 of 1,812 asthmatic women and for 867 of 881 controls. Of the asthma subjects, 30.7% (521) were obese compared with 25.5% of the controls, P = .006. Obese women, regardless of whether they had asthma, were more likely to undergo cesarean delivery (OR 1.6, 95% confidence interval [CI]1.3-2.0) to develop preeclampsia or gestational hypertension (OR 1.7 95% CI 1.3-2.3) and gestational diabetes (OR 4.2, 95% CI 2.8-6.3). There were no differences in the rates of overall asthma improvement (20.6% compared with 23.6%, P = .36) or deterioration (33.3% compared with 28.8%, P = .20) between obese and nonobese asthma patients. After adjustment for confounding variables, obesity, not asthma, was associated with nonpulmonary complications of pregnancy, and obesity was associated with an increase in asthma exacerbations as well (OR 1.3, 95% CI 1.1-1.7).
  
  
  CONCLUSIONS
  Obesity is associated with an increased risk of asthma exacerbations during pregnancy. The increased rate of nonpulmonary complications of pregnancy in asthma patients is associated with obesity in this population and not with asthma status.
  
  
  METHODS
  II-1.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hutzel Hospital-Wayne State University, Detroit, Michigan 48201, USA. ihendler@med.wayne.edu
authors.forename: Israel
authors.initials: I
authors.lastname: Hendler
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Valerija
authors.initials: V
authors.lastname: Momirova
authors.forename: Robert
authors.initials: R
authors.lastname: Wise
authors.forename: Mark
authors.initials: M
authors.lastname: Landon
authors.forename: William
authors.initials: W
authors.lastname: Mabie
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: James
authors.initials: J
authors.lastname: Kiley
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.forename: Atef
authors.initials: A
authors.lastname: Moawad
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Paul
authors.initials: P
authors.lastname: Meis
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Richard H
authors.initials: RH
authors.lastname: Paul
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: O'sullivan
authors.forename: Gary R
authors.initials: GR
authors.lastname: Thurnau
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Conway
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications*; D001724:Birth Weight; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008171:Lung Diseases / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D011225:Pre-Eclampsia / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012044:Regression Analysis; D012720:Severity of Illness Index