Asthma and reproductive outcomes: A Danish nationwide cohort study

Anne Vejen Hansen, Kjell E. J. Håkansson, Anders P. Mikkelsen, Zarqa Ali, Anja Pinborg, Øjvind Lidegaard, Charlotte S. Ulrik

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Abstract

Background: Asthma is common among women of reproductive age. Prior studies revealed associations between asthma and fertility by reporting prolonged time to pregnancy and altered fecundability.

Aim: Investigate fertility in women treated with anti-asthmatic drugs (ICS/LABA/LAMA/SABA/LTRA) compared to non-asthmatic controls.

Method: All Danish women born 1976 to 1999 were followed from 1994 to 2017. Asthma was identified by repeated redemption of anti-asthmatic drugs with severity per 2018 GINA guidelines. Outcome were fertility treatment, compared to controls applying a Cox regression model adjusted for age, calendar year, and education.

Results: In total, 769,880 were included and followed (median time of 10.8 years [IQR 5.3-17.5]). The proportion who gave birth in follow-up was 77%, irrespective of asthma exposure. However, women with asthma experienced higher degree of fetal loss (17.0% vs. 15.7%) and more use of fertility treatment (5.6% vs. 5.0%) compared to controls. Risk of fertility treatment was significantly higher in women with asthma: HR 1.12(1.08-1.15). GINA step 4-5 had the highest risk of needing fertility treatment: HR 1.62(1.43-1.83) and women with ≥ 3 prior exacerbations had an increased risk of needing fertility treatment: HR 1.38(1.19-1.60).

Conclusion: Although women with asthma more often require fertility treatment, a risk correlated to asthma severity and exacerbations, asthma does not seem to affect the number of live births.
Original languageEnglish
JournalThe European Respiratory Journal
Volume64
Issue numberSuppl 68
Pages (from-to)OA5579
Number of pages1
ISSN0903-1936
DOIs
Publication statusPublished - 2024

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