Nosečnost in porod žensk z astmo: pregled literature : diplomsko delo

Vrabič, Ana (author), Prelec, Anita (mentor), Starc, Andrej (reviewer)

Uvod: Astma je kronična pljučna bolezen dihal, za katero sta značilna vnetje in zategovanje mišic okoli dihalnih poti. Med glavne simptome štejemo kašelj, piskanje, oteženo dihanje in stiskanje v prsih. Ti simptomi so lahko blagi ali hudi in se pojavljajo ter izginjajo. Astma prizadene okoli 12 % nosečnic. Namen: Namen je raziskati, kateri dejavniki vplivajo na potek astme v nosečnosti, kako astma vpliva na porodne izide ter kakšna je vloga babice in drugih zdravstvenih delavcev pri spremljanju in vodenju nosečnic z astmo. Metode dela: Uporabili smo deskriptivno metodo dela s pregledom znanstvene in strokovne literature, objavljene med letoma 2014 in 2024. Ker je literatura v slovenskem jeziku omejena, smo se osredotočili na vire v angleškem jeziku. Članke smo iskali v podatkovnih bazah Medline (Pubmed), Cinahl, Springerlink, ScienceDirect in Cochrane Library. Vključitveno merilo je bilo tudi, da je bil članek dostopen v celoti. Rezultati: V pregled literature smo vključili 22 virov. Astma v nosečnosti, zlasti nenadzorovana, povečuje tveganje za prirojene anomalije, prezgodnji porod, preeklampsijo, majhen plod za gestacijsko starost, gestacijski diabetes, nosečnostno hipertenzijo, carski rez, prezgodnji razpok ovojev, perinatalno umrljivost in asfiksijo. Tveganje ob uporabi inhalacijskih kortikosteroidov je majhno, večje tveganje pa je povezano z ß2-agonisti in sistemskimi kortikosteroidi. Onesnaževalci v okolju, nestabilno psihično stanje nosečnice z astmo in visoke vrednosti skupnih IgE slabšajo izide nosečnosti z astmo, medtem ko starost nosečnice, socialno-ekonomski status in rasne/etnične razlike nimajo velikega vpliva. Babice potrebujejo jasne smernice za zdravstvenovzgojno delo z ženskami. Razprava in zaključek: Astma v nosečnosti zahteva celostno obravnavo. Pravilna uporaba inhalacijskih kortikosteroidov zmanjšuje perinatalna tveganja, medtem ko farmakološki, okoljski in psihosocialni dejavniki vplivajo na njen potek. Predlagano je rutinsko merjenje serumskega IgE v prvem tromesečju pri zmerni/hudi astmi kot prognostični marker za majhnega otroka glede na gestacijsko starost in hipertenzivne motnje pri novorojenčkih. Babice lahko z dodatnim znanjem izboljšajo spremljanje nosečnic z astmo. Klinične smernice za interdisciplinarno sodelovanje v zdravstveni obravnavi žensk z astmo bi lahko izboljšale zdravstvene izide.

• Language: Slovenian
• Keywords: diplomska dela, babištvo, respiratorna obolenja, nosečnost, obporodno obdobje, multidisciplinarni pristop, babice
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Vrabič]
• Year: 2025
• Number of pages: 43 str.
• PID: 20.500.12556/RUL-177311
• UDC: 618.2/.7
• COBISS.SI-ID: 262462211
• Publication date in RUL: 20.12.2025

Secondary language

• Language: English
• Title: Pregnancy and childbirth of women with asthma: a literature review : diploma work

Abstract

Introduction: Asthma is a chronic respiratory disease characterized by inflammation and tightening of the muscles around the airways. The main symptoms include coughing, wheezing, difficulty breathing, and chest tightness. These symptoms can be mild or severe and come and go. Asthma affects about 12% of pregnant women. Purpose: The purpose is to investigate which factors influence the course of asthma during pregnancy, how asthma affects birth outcomes, and what role midwives and other healthcare professionals play in the care and management of pregnant women with asthma. Methods: We used a descriptive method with a review of scientific and professional literature published between 2014 and 2024. As the literature in Slovenian is limited, we focused on sources in English. We searched for articles in the Medline (Pubmed), Cinahl, Springerlink, ScienceDirect, and Cochrane Library databases. Another inclusion criterion was that the article had to be available in its entirety. Results: We included 22 sources in our literature review. Asthma during pregnancy, especially uncontrolled asthma, increases the risk of congenital anomalies, preterm birth, preeclampsia, small for gestational age, gestational diabetes, gestational hypertension, cesarean section, premature rupture of membranes, perinatal mortality, and asphyxia. The risk associated with the use of inhaled corticosteroids is low, while a higher risk is associated with β2-agonists and systemic corticosteroids. Environmental pollutants, unstable mental state of pregnant women with asthma, and high total IgE levels worsen pregnancy outcomes in women with asthma, while the age of the pregnant woman, socioeconomic status, and racial/ethnic differences do not have a significant impact. Midwives need clear guidelines for health education work with women. Discussion and conclusion: Asthma in pregnancy requires a comprehensive approach. Proper use of inhaled corticosteroids reduces perinatal risks, while pharmacological, environmental, and psychosocial factors influence its course. Routine measurement of serum IgE in the first trimester in moderate/severe asthma is suggested as a prognostic marker for small for gestational age and hypertensive disorders in newborn. Midwives can improve the monitoring of pregnant women with asthma with additional knowledge. Clinical guidelines for interdisciplinary collaboration in the medical care of women with asthma could improve health outcomes.

• Keywords: diploma theses, midwifery, respiratory disease, pregnancy, perinatal period, multidisciplinary approach, midwives