Respiratory Complications in Pregnancy: Maternal and Neonatal Outcomes from a Retrospective Analysis

Introduction: The frequency and significance of acute and chronic respiratory disorders in pregnant women have increased in recent years. Pregnant women with respiratory conditions, ranging from asthma to adult respiratory distress syndrome, should be promptly diagnosed and treated. Clinicians must have an understanding of cardiopulmonary physiology to promptly recognize and treat pregnant women with respiratory conditions ranging from asthma to adult respiratory distress syndrome. Significant changes are seen in respiratory parameters as pregnancy progresses.

Aim: The aim of this study is to determine the prevalence of respiratory diseases in pregnancy in a tertiary healthcare hospital and assess the maternal and perinatal outcomes in pregnant women with respiratory disease and complications.

Materials and Methods: This study was a retrospective record study, which analyzed various respiratory diseases in pregnancy and their effects on the perinatal outcome. Hospital documents of pregnant women who delivered in the institution during the years 2015–2019 were studied. Pregnant women with respiratory complications in pregnancy including new onset/or exacerbations of preexisting respiratory diseases like asthma, acute bronchitis, acute respiratory distress syndrome (ARDS), and pneumonia were noted. Data were analyzed using the SPSS version 16 after it was manually entered in Microsoft Excel. Pearson’s Chi square and Fisher’s exact test were used as the tests for significance, and a value <0.05 was considered significant.

Results: The study identified 214 pregnant women with respiratory complications over a period of 5 years. The overall incidence was 2.3%; 94.4% were 20–35 years of age, and 82.2% delivered at term gestation (37–40 weeks). Respiratory complications like infective, restrictive, and obstructive lung diseases were seen. Bronchial asthma exacerbations in 155 (72%), respiratory tract infections (upper and lower respiratory tract infections) in 23 (10.7%), acute bronchitis in 16 (7.5%), ARDS in 8 (3.7%), pleural effusion in 3 (1.4%), tuberculosis in 2 (0.9%) and OSA in 1 (0.5%) were seen. A total of 3.2% had intensive care unit (ICU) admissions, and there was 1.4% maternal mortality. The following observations were made in women with respiratory complications: a higher incidence of preeclampsia in 31 (14.4%), an increased rate of lower segment cesarean sections (LSCS) in 99 (46.2%), intrauterine death (IUD) in 12 (5.6%), and poor Apgar scores as well as neonatal intensive care unit (NICU) admissions in 99 (46.3%) women.

Conclusion: Respiratory illnesses in pregnancy pose more risk to the mother than to the fetus. Close monitoring of the antenatal period with pulmonary function testing increases the chance of a good pregnancy outcome. Mothers with respiratory diseases should be screened antenatally as the chances of preterm and intrauterine growth restriction (IUGR) are high in the fetus. Close monitoring of the antenatal period with pulmonary function testing increases the chance of a good outcome of the present pregnancy.