title: Impact of a history of maternal depression and anxiety on asthma control during pregnancy.
abstract: OBJECTIVE
  To determine the impact of self-reported maternal depression/anxiety on asthma control during pregnancy.
  
  
  METHODS
  Pregnant women with a doctor diagnosis of asthma (n = 189) were prospectively recruited at their antenatal booking visit, and the presence of maternal depression and anxiety was identified using self-report and routine questionnaire assessments. Data on exacerbations and asthma control were collected during gestation. Asthma control was assessed using the Juniper Asthma Control Questionnaire (ACQ) and women were classified as having recurrent uncontrolled asthma if their ACQ score was >1.5 during two or more consecutive study visits. Exacerbations were defined as events that led to increased treatment requirements, and doctor or hospital visits.
  
  
  RESULTS
  There were 85 women with self-reported depression/anxiety and 104 women without self-reported depression/anxiety. The presence of depression/anxiety was associated with an increased likelihood (adjusted hazard ratio (HR) 1.67: 95% confidence interval (CI) 1.03-2.72) and incidence (adjusted incidence rate ratio (IRR) 1.71: 95% CI 1.13-2.58) of uncontrolled asthma during pregnancy, as well as an increased risk of recurrent uncontrolled asthma during 2 or more study visits (adjusted relative risk (RR) 1.98: 95% CI 1.00-3.91). No impact of depression/anxiety was observed with respect to the likelihood (adjusted HR 0.70: 95% CI 0.35-1.41) or incidence of exacerbations during pregnancy (adjusted IRR 0.66: 95% CI 0.35-1.26).
  
  
  CONCLUSIONS
  This study provides evidence that the presence of maternal depression/anxiety is associated with an increased likelihood and incidence of uncontrolled asthma during pregnancy. Given the high prevalence of co-morbid depression/anxiety among asthmatics, further research investigating such associations is urgently required.
authors.affiliation: a Robinson Research Institute, School of Medicine, University of Adelaide , Adelaide , Australia.|b SA Pharmacy, Pharmacy Department , Flinders Medical Centre , Adelaide , Australia.
authors.forename: Luke E
authors.initials: LE
authors.lastname: Grzeskowiak
authors.affiliation: c Respiratory Medicine Unit , The Queen Elizabeth Hospital , Adelaide , Australia.
authors.forename: Brian
authors.initials: B
authors.lastname: Smith
authors.affiliation: c Respiratory Medicine Unit , The Queen Elizabeth Hospital , Adelaide , Australia.
authors.forename: Anil
authors.initials: A
authors.lastname: Roy
authors.affiliation: d Discipline of Psychiatry, School of Medicine, University of Adelaide , Adelaide , Australia.
authors.forename: K Oliver
authors.initials: KO
authors.lastname: Schubert
authors.affiliation: d Discipline of Psychiatry, School of Medicine, University of Adelaide , Adelaide , Australia.
authors.forename: Bernhard T
authors.initials: BT
authors.lastname: Baune
authors.affiliation: a Robinson Research Institute, School of Medicine, University of Adelaide , Adelaide , Australia.
authors.forename: Gustaaf A
authors.initials: GA
authors.lastname: Dekker
authors.affiliation: a Robinson Research Institute, School of Medicine, University of Adelaide , Adelaide , Australia.|e Mater Medical Research Institute, University of Queensland , Brisbane , Australia.
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Clifton
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001007:Anxiety / Q000453:epidemiology*; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D057566:Self Report; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Anxiety; asthma; asthma control; depression; mental health; pregnancy