title: Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life.
abstract: OBJECTIVE
  To describe the pattern and severity of rhinitis in pregnancy and the impact rhinitis has on asthma control and quality of life (QoL) in pregnant women with asthma.
  
  
  METHODS
  Two hundred and eighteen non-smoking pregnant women with asthma were participants in a randomised controlled trial of exhaled nitric oxide guided treatment adjustment. Rhinitis was assessed using a visual analogue scale (VAS) scored from 0 to 10 and classified as current (VAS > 2.5), moderate/severe versus mild (VAS > 6 vs <5), atopic versus non-atopic and pregnancy rhinitis. At baseline, women completed the 20-Item Sino-Nasal Outcome Test (SNOT20), asthma-specific (AQLQ-M) QoL questionnaires and the Six-Item Short-Form State Trait Anxiety Inventory (STAI-6). Asthma control was assessed using the asthma control questionnaire (ACQ). Perinatal outcomes were collected after delivery.
  
  
  RESULTS
  Current rhinitis was present in 142 (65%) women including 45 (20%) women who developed pregnancy rhinitis. Women with current rhinitis had higher scores for ACQ (p = 0.004), SNOT20 (p < 0.0001) and AQLQ-M (p < 0.0001) compared to women with no rhinitis. Current rhinitis was associated with increased anxiety symptoms (p = 0.002), rhinitis severity was associated with higher ACQ score (p = 0.004) and atopic rhinitis was associated with poorer lung function (p = 0.037). Rhinitis symptom severity improved significantly during gestation (p < 0.0001). There was no impact on perinatal outcomes. Improved asthma control was associated with improvement in rhinitis.
  
  
  CONCLUSIONS
  Rhinitis in pregnant women with asthma is common and associated with poorer asthma control, sino-nasal and asthma-specific QoL impairment and anxiety. In the context of active asthma management there was significant improvement in rhinitis symptoms and severity as pregnancy progressed.
authors.affiliation: a Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia .|b Department of Respiratory and Sleep Medicine , John Hunter Hospital , Newcastle , NSW , Australia .
authors.forename: Heather
authors.initials: H
authors.lastname: Powell
authors.affiliation: a Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia .
authors.forename: Vanessa E
authors.initials: VE
authors.lastname: Murphy
authors.affiliation: a Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia .|b Department of Respiratory and Sleep Medicine , John Hunter Hospital , Newcastle , NSW , Australia .
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hensley
authors.affiliation: c Obstetrics, Gynaecology and Neonatal, Northern Clinical School, University of Sydney , Sydney , NSW , Australia .|d Royal North Shore Hospital , Sydney , NSW , Australia , and.
authors.forename: Warwick
authors.initials: W
authors.lastname: Giles
authors.affiliation: e Robinson Institute, Department Obstetrics and Gynaecology, University of Adelaide , SA , Australia.
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Clifton
authors.affiliation: a Centre for Asthma and Respiratory Diseases, University of Newcastle and Hunter Medical Research Institute , Newcastle , NSW , Australia .|b Department of Respiratory and Sleep Medicine , John Hunter Hospital , Newcastle , NSW , Australia .
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gibson
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001007:Anxiety / Q000453:epidemiology; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology*; D001944:Breath Tests; D005260:Female; D006304:Health Status; D006801:Humans; D008603:Mental Health; D009569:Nitric Oxide / Q000032:analysis; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011788:Quality of Life; D012220:Rhinitis / Q000453:epidemiology*; D065631:Rhinitis, Allergic / Q000453:epidemiology; D012720:Severity of Illness Index
chemical_list: D018927:Anti-Asthmatic Agents; D009569:Nitric Oxide
keywords: Asthma control; pregnancy; quality of life; rhinitis