Pregnancy Publications
2022
The impact of prolonged landscape fire smoke exposure on women with asthma in Australia
Tesfalidet Beyene, Vanessa E Murphy, Peter G Gibson, Vanessa M McDonald, Joe Van Buskirk, Elizabeth G Holliday, Anne E Vertigan, Jay C Horvat, Graeme R Zosky, Geoffrey G Morgan, Edward Jegasothy, Ivan Hanigan, Joerg Mattes, Adam M Collison, Megan E Jensen, BMC Pregnancy and Childbirth 2022
Why this is important
Little is known about the physical and mental health impact of bushfire smoke on women with asthma, including those who are pregnant or breastfeeding.
How did we investigate this
BLT participants were asked to complete a survey about general and respiratory health outcomes experienced during and after the 2019/2020 Australian bushfire period along with actions taken to minimise exposure. The impact of prolonged bushfires on quality of life, anxiety and psychological stress were also assessed.
Daily 24-hour mean fine particulate matter (particulate matter of 2.5 μm or less in diameter, PM2.5) data from fixed-site government air quality monitoring stations was obtained.
What we found
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82% of women reported general symptoms during the fire period and 41% reported persistent symptoms following and higher anxiety scores during the fire period.
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2 in 5 women were concerned about the effect of the bushfires on their pregnancy
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Less then half received advice on asthma management or smoke reduction strategies. Participants had higher anxiety during the bushfire period
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During this fire period participants were exposed to PM2.5 levels above the WHO 24hr air-quality guideline
What this means
The findings highlight the need for consistent public health messages, resources and support during bushfire events to protect the physical and mental health of women with asthma.
The effect of asthma management with exhaled nitric oxide (FENO) versus usual care on perinatal outcomes
Vanessa E Murphy, Megan E Jensen, Elizabeth G Holliday, Warwick B Giles, Helen L Barrett, Leonie K Callaway, Andrew Bisits, Michael J Peek, Sean K Seeho, Alistair Abbott, Annelies L Robijn, Paul B Colditz, Andrew Searles, John Attia, Kirsten McCaffery, Michael J Hensley, Joerg Mattes, Peter G Gibson, European Respiratory Journal 2022
Why this is important
Asthma during pregnancy is linked to unfavorable birth outcomes such as preterm birth, low birth weight, stillbirth, neonatal ICU admission and neonatal death.
How did we investigate this
Fractional exhaled nitric oxide (FENO) is an indicator of airways inflammation. For this study we compared the following two groups, both consisting of pregnant women recruited between 12-23 weeks of pregnancy:
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FENO guided asthma management group - this group had their medication adjusted according to FENO and symptoms.
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Usual care group - this group did not have their medication adjusted as part of the trial.
Both groups were provided with education on asthma management and medication safety.
What we found
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Between the two groups there was no significant differences in any of the birth outcomes .
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There was no significant effect on maternal asthma exacerbations in the FENO group.
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Poor asthma management skills were observed amongst the pregnant women within the study.
What this means
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FENO-based asthma management during pregnancy for the purpose of improving birth outcomes is not supported by this study.
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The need for improvements in asthma management during pregnancy and education on medication safety during pregnancy has been highlighted.
Factors Associated with Asthma Exacerbations
During Pregnancy
Marleen P. Bokern, Annelies L. Robijn, Megan E. Jensen, Daniel Barker, Leonie Callaway, Vicki Clifton, Peter Wark, Warwick Giles, Joerg Mattes, Michael Peek, John Attia, Sean Seeho, Alistair Abbott, Peter G. Gibson, Vanessa E. Murphy, The Journal of Allergy and Clinical Immunology: In Practice 2022
Why this is important
Asthma exacerbations during pregnancy are associated with unfavorable pregnancy outcomes. Identifying factors associated with asthma exacerbations during pregnancy could help health professionals improve asthma management during pregnancy.
How did we investigate this
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Routinely collected data from three cohorts of pregnant women with asthma including the Breathing for Life Trial (BLT) was analysed
What we found
- Asthma attacks before pregnancy and more severe asthma at the beginning of pregnancy were linked with an increased risk of exacerbations during pregnancy
What this means
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Asthma exacerbations during pregnancy may be predicted by current and past asthma control and severity. Some of these variables are markers of more severe disease
2021
Longitudinal Analysis of Lung Function in Pregnant Women
with and without Asthma
Megan E. Jensen, Annelies L. Robijn, Peter G. Gibson,
Christopher Oldmeadow, and Managing Asthma in Pregnancy study collaborative group; Breathing for Life Trial collaborative group and Vanessa E. Murphy, Journal Allergy Clinical Immunology 2021
Why this is important
Spirometry is commonly used to monitor lung function. It has been shown to be a useful clinical asthma management tool, its value in pregnancy is unclear due to a lack of large studies investigating lung function across the pregnancy. This study investigates the effects of pregnancy progression on lung function.
How did we investigate this
The effects of pregnancy progression and its interaction with asthma on the following spirometry lung function measures were examined in four cohorts of pregnant women with and without asthma including the Breathing for Life Trial (BLT).
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FEV1 - the amount of air you can force from your lungs in one second.
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FVC (Forced vital capacity) - the amount of air you can force from your lungs after taking the deepest breath possible.
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FEV1:FVC% a ratio that reflects the amount of air you can force from your lungs.
What we found
Pregnancy progression decreased FVC% and FEV1% consistent with the physical changes to the chest cavity happening during pregnancy. Notably:
- FVC% declined with pregnancy progression at the same rate in women with and without asthma
- FEV1% remained fairly stable in women with asthma but decreased significantly for women without asthma
- FEV1:FVC% increased marginally in asthmatic women
What this means
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Results may be due to active asthma management during pregnancy indicating that better asthma management during pregnancy may decrease the negative effects of pregnancy progression on lung function
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Spirometry may be used in clinical assessment and education during pregnancy
2020
Fractional exhaled nitric oxide‐based asthma management: The feasibility of its implementation into antenatal care in New South Wales, Australia
Karen McLaughlin, Megan E. Jensen, Maralyn Foureur, Peter G. Gibson and Vanessa E. Murphy, The Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG) 2020
The acceptability and feasibility of implementing a Fractional exhaled Nitric Oxide (FeNO)-based asthma management strategy into antenatal care: The perspective of pregnant women with asthma
Karen McLaughlin, Megan E. Jensen, Maralyn Foureur, Peter Gibson, Conceptualisation, Vanessa E Murphy, Midwifery 2020
Factors Associated with Nonadherence to Inhaled Corticosteroids for Asthma During Pregnancy
Annelies L. Robijn, Daniel Barker, Peter G. Gibson, Warwick B. Giles, Vicki L. Clifton, Joerg Mattes, Michael J. Peek, Helen L. Barrett, Sean K. Seeho, Leonie K. Callaway, Alistair Abbott, John Attia, Peter A. Wark, Megan E. Jensen and
Vanessa E. Murphy, Journal Allergy Clinical Immunology 2020
2019
Trends in asthma self-management skills and inhaled corticosteroid use during
pregnancy and postpartum
from 2004 to 2017
Annelies L. Robijn, Megan E. Jensen, Peter G. Gibson,
Heather Powell, Warwick B. Giles, Vicki L. Clifton, Joerg Mattes,
Michael J. Peek, Helen L. Barrett, Sean K. Seeho,
Leonie K. Callaway, Alistair Abbott, John Attia, Peter A. Wark,
and Vanessa E. Murphy, Journal of Asthma 2019
2016
The Breathing for Life Trial: a randomised controlled trial of fractional exhaled nitric oxide (FENO)-based management of asthma during pregnancy and its impact on perinatal outcomes and infant and childhood respiratory health
Vanessa E. Murphy, Megan E. Jensen, Joerg Mattes, Michael J. Hensley, Warwick B. Giles, Michael J. Peek,
Andrew Bisits, Leonie K. Callaway, Kirsten McCaffery, Helen L. Barrett, Paul B. Colditz, Sean K. Seeho,
John Attia, Andrew Searles, Christopher Doran, Heather Powell and Peter G. Gibson BMC Pregnancy and Childbirth 2016