title: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Respiratory & Sleep Medicine, Hunter Medical Research Institute, John Hunter Hospital, Newcastle, NSW, Australia.
authors.forename: Heather
authors.initials: H
authors.lastname: Powell
authors.forename: Kirsten
authors.initials: K
authors.lastname: McCaffery
authors.forename: Vanessa E
authors.initials: VE
authors.lastname: Murphy
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hensley
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Clifton
authors.forename: Warwick
authors.initials: W
authors.lastname: Giles
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gibson
mesh_terms: D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000209:etiology; D001249:Asthma / Q000188:drug therapy / Q000523:psychology*; D001294:Attitude to Health; D005260:Female; D005333:Fetus / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D055118:Medication Adherence; D010465:Perception; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life; D012306:Risk; D011795:Surveys and Questionnaires; D013723:Teratogens
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids; D013723:Teratogens