Conclusions: Clinical practice guidelines based on the latest evidence do not guarantee clinical efficacy. After guideline revision, asthma-associated risks of any Cesarean section (p < 0.001), any antenatal corticosteroids (p = 0.041), and small for gestational age (p = 0.050), but not IUGR and Cesarean section without labor, were reduced. Results: Overall, maternal asthma was associated with increased risks of any antenatal corticosteroid treatment for threatened preterm birth (aOR 1.319, 95% CI 1.078–1.614), any Cesarean section (aOR 1.196, 95% CI 1.059–1.351), Cesarean section without labor (aOR 1.241, 95% CI 1.067–1.444), intrauterine growth restriction (IUGR, aOR 1.285, 95% CI 1.026–1.61), and small for gestational age (aOR 1.324, 95% CI 1.136–1.542). In imputation (n = 59131) and complete case datasets (n = 49594), analyses were conducted by inverse proportional weighting and multivariate logistic regression, accounting for confounders.
Maternal asthma (prevalence:7.5%) was defined as asthma medication use or symptoms described to midwives. Methods: Routinely collected perinatal and neonatal datasets from the Women’s and Children’s Hospital (Adelaide, Australia) were linked. This study investigated if these revised guidelines reduced the impact of maternal asthma on risks of adverse perinatal outcomes before (Epoch 1, 2006–2011) and after the revision (Epoch 2, 2013–2018). Consequently, the South Australian ‘Asthma in Pregnancy’ perinatal guidelines were revised in 2012 to address management according to severity. Objective: Asthma occurs in ∼17% of Australian pregnancies and is associated with adverse perinatal outcomes, which worsen with poor asthma control.
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