A32-11 Asthma in Pregnancy: A Descriptive Study of Clinical Factors and Outcomes at a Single Academic Center

Abstract Rationale Asthma is the most common respiratory condition complicating pregnancy and is associated with significant maternal and neonatal morbidity when uncontrolled. Despite national guidelines emphasizing the safety of controller medications in pregnancy, asthma-related complications remain prevalent. This study aimed to characterize the clinical features, asthma management, and outcomes of pregnant patients with asthma at a single academic center over a five-year period. Methods This retrospective cohort study reviewed electronic medical records of patients aged 18-50 with an ICD-10 coded diagnosis of asthma who delivered at UConn Health Center between 2018 and 2023. Demographic data, asthma severity, inhaler use, tobacco history, psychiatric comorbidities, BMI trends across trimesters, and pregnancy outcomes were extracted and analyzed. Asthma trajectory was stratified into “worsened,” “stable,” or “improved” groups based on documented symptom burden and exacerbation frequency during pregnancy. Results Among 845 total deliveries, 147 asthmatic pregnancies were reviewed to date. The majority of patients (77.6%) had stable asthma, with 15% categorized as worsened and 1% as improved; patients with moderate persistent asthma experienced a higher burden of complications and preterm delivery. Current smokers exhibited elevated rates of viral respiratory infections. Patients whose asthma worsened during pregnancy had greater total weight gain compared to those who improved, though the latter group was a small subset. Obesity prevalence was 53.4%. Use of inhaled corticosteroids varied widely, and objective assessment of asthma control was limited: only 8.8% of patients had pulmonary function testing and 2.7% had a documented ACT during pregnancy. The cohort had a median age of 30.0 years (IQR 24.5-35.0), with over half publicly insured (Medicaid 57%). The most common racial and ethnic groups represented were Hispanic and Black or African American patients. Conclusions In this cohort, objective measures of asthma control—such as pulmonary function testing and ACT use—were infrequently documented, and obesity was highly prevalent. Patients with worsened asthma during pregnancy experienced greater weight gain and more clinical complications, highlighting the need for earlier identification and closer monitoring of at-risk individuals. Given the high proportion of patients who were publicly insured and identified as Hispanic or Black, the limited use of asthma screening tools raises concern for potential disparities in care. These findings support the development of an institution-wide protocol to improve assessment and outpatient follow-up during pregnancy. Future efforts will focus on expanding this analysis and implementing systems-level interventions to address gaps in maternal asthma care. This abstract is funded by: None