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. 2022 Apr 20;17(4):e0267122.
doi: 10.1371/journal.pone.0267122. eCollection 2022.

Maternal body composition and gestational weight gain in relation to asthma control during pregnancy

Danielle R Stevens  1 , Matthew C H Rohn  1 , Stefanie N Hinkle  1 , Andrew D Williams  2 , Rajesh Kumar  3 , Leah M Lipsky  1 , William Grobman  3 , Seth Sherman  4 , Jenna Kanner  1 , Zhen Chen  1 , Pauline Mendola  1   5
Affiliations

Maternal body composition and gestational weight gain in relation to asthma control during pregnancy

Danielle R Stevens et al. PLoS One. .

Abstract

Background: Poor asthma control is common during pregnancy and contributes to adverse pregnancy outcomes. Identification of risk factors for poor gestational asthma control is crucial.

Objective: Examine associations of body composition and gestational weight gain with asthma control in a prospective pregnancy cohort (n = 299).

Methods: Exposures included pre-pregnancy body mass index (BMI), first trimester skinfolds, and trimester-specific gestational weight gain. Outcomes included percent predicted forced expiratory volumes (FEV1, FEV6), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC, symptoms (activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms), and exacerbations (asthma attacks, medical encounters). Linear and Poisson models examined associations with lung function (β (95% confidence interval (CI)), asthma symptom burden (relative rate ratio (RR (95%CI)), and exacerbations (RR (95%CI)).

Results: Women with a BMI ≥ 30 had lower percent predicted FVC across pregnancy (βThirdTrimester: -5.20 (-8.61, -1.78)) and more frequent night symptoms in the first trimester (RR: 1.66 (1.08, 2.56)). Higher first trimester skinfolds were associated with lower FEV1, FEV6, and FVC, and more frequent night symptoms and inhaler use across pregnancy. Excessive first trimester gestational weight gain was associated with more frequent activity limitation in the first trimester (RR: 3.36 (1.15, 9.80)) and inhaler use across pregnancy (RRThirdTrimester: 3.49 (1.21, 10.02)).

Conclusions: Higher adiposity and first trimester excessive gestational weight gain were associated with restrictive changes in lung function and symptomology during pregnancy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of study population for women in the Breathe-Wellbeing, Environment, Lifestyle, and Lung Function Study, 2015–2019, USA.
Fig 2
Fig 2. Estimated means and 95% confidence intervals for lung function per trimester by pre-pregnancy BMI and GWG in the Breathe-Wellbeing, Environment, Lifestyle, and Lung Function Study, 2015–2019, USA.
Abbreviations: % FEV1, percent predicted forced expiratory volume in 1 second; % FEV6, percent predicted forced expiratory volume in 6 seconds; % FVC, percent predicted forced vital capacity; % PEF, percent predicted peak flow; BMI, body mass index; FEV1/FVC, ratio of forced expiratory volume in 1 second to forced vital capacity; GWG, gestational weight gain.
Fig 3
Fig 3. Estimated mean days and 95% confidence intervals of asthma symptom burden per trimester by pre-pregnancy BMI and GWG in the Breathe-Wellbeing, Environment, Lifestyle, and Lung Function Study, 2015–2019, USA.
Abbreviations: BMI, body mass index; GWG, gestational weight gain.
Fig 4
Fig 4. Estimated mean number and 95% confidence intervals for asthma exacerbations during pregnancy by pre-pregnancy BMI and GWG in the Breathe-Wellbeing, Environment, Lifestyle, and Lung Function Study, 2015–2019, USA.
Abbreviations: BMI, body mass index; GWG, gestational weight gain.
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