Clinical characteristics of severe asthma exacerbations among inner-city women in pregnancy

The city of Philadelphia, and the zip codes adjacent to our institution in particular, have been previously noted to be “epicenters” of US asthma morbidity and mortality, in part due to issues of poverty and race.6 Carroll et al7 examined racial differences in the incidence of asthma exacerbations in a low-income population of pregnant women and noted that the proportion of emergency room (ER) presentations and hospital admissions was significantly higher among blacks than among whites. Adverse maternal outcomes for patients with asthma have also been observed to be higher in minorities.8 Therefore, the objectives of our study are to characterize a cohort of inner-city pregnant women who experienced severe prenatal asthma exacerbation and identify potential risk factors associated with poor asthma control. [...]the low PEFRs recorded at the time of initial ER or hospital evaluation may be indicative of relatively late presentations for medical care during exacerbations. Variable Statistic Cases (N = 62) Controls (N = 227) P value Maternal age at delivery (y) n 62 227 .4235 Mean ± SD 26.5 ± 6.3 25.7 ± 6.0 Range 15-41 15-42 Race Black (non-Hispanic) n (%) 45 (72.6) 170 (74.9) .5802 White (non-Hispanic) 8 (12.9) 22 (9.7) Other 5 (8.1) 26 (11.5) Missing 4 (6.5) 9 (4.0) Insurance status Insured n (%) 60 (96.8) 223 (98.2) .2392 Uninsured 2 (3.2) 2 (0.9) Missing 0 2 (0.9) Insurance type Public n (%) 38 (61.3) 159 (70.0) .2950 Private 22 (35.5) 64 (28.2) Missing 2 (3.2) 4 (1.8) Parity n 60 227 .6640 Mean ± SD 1.5 ± 1.3 1.4 ± 1.6 Range 0-5 0-10 Gravidity n 60 227 .8614 Mean ± SD 3.3 ± 1.9 3.2 ± 2.2 Range 1-9 1-10 Gestational age at birth (wk) n 40 222 .3135 Mean ± SD 37.7 ± 2.7 38.2 ± 2.7 Range 26-41 23-43 Infant birthweight (g) n 31 212 .3218 Mean ± SD 3252.5 ± 782.7 3104.8 ± 628.9 Range 2442-6165 572-5100 Infant sex Male n (%) 23 (37.1) 122 (53.7)