妊娠哮喘可治療特質及生物制劑應用_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

譙猗丹 ¹ , 鄧稞 ^1,2 , 周淑 ³ , 王霽 ^1,2 ,  王剛 ^1,2

1. ;
2. ;
3. ;

Corresponding?author：

王剛, Email: wong-gang@126.com

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DOI：

10.7507/1671-6205.202603054

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Citation： 譙猗丹, 鄧稞, 周淑, 王霽, 王剛. 妊娠哮喘可治療特質及生物制劑應用. Chinese Journal of Respiratory and Critical Care Medicine, 2026, 25(5): 356-362. doi: 10.7507/1671-6205.202603054 Copy

1.	Fuhlbrigge AL, Sharma S. Unraveling the heterogeneity of asthma: Decoding subtypes of asthma. J Allergy Clin Immunol, 2025, 156(1): 41-50.
2.	Song WJ, Kang MG, Chang YS, et al. Epidemiology of adult asthma in asia: Toward a better understanding. Asia Pac Allergy, 2014, 4(2): 75-85.
3.	Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet, 2019, 394(10196): 407-418.
4.	Chapman KR, Boulet LP, Rea RM, et al. Suboptimal asthma control: Prevalence, detection and consequences in general practice. Eur Respir J, 2008, 31(2): 320-325.
5.	蘇楠, 林江濤, 劉國梁, 等. 我國8省市支氣管哮喘患者控制水平的流行病學調查. 中華內科雜志, 2014, 53(8): 601-606.
6.	Kwon HL, Triche EW, Belanger K, et al. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am, 2006, 26(1): 29-62.
7.	Li T, Dong F, Li N, et al. Maternal and perinatal outcomes of asthma exacerbation during pregnancy in a Chinese population: a retrospective cohort study. BMC Pulm Med, 2024, 24(1): 296.
8.	Tamási L, Horváth I, Bohács A, et al. Asthma in pregnancy--immunological changes and clinical management. Respir Med, 2011, 105(2): 159-164.
9.	Maselli DJ, Adams SG, Peters JI, et al. Management of asthma during pregnancy. Ther Adv Respir Dis, 2013, 7(2): 87-100.
10.	Murphy VE, Robijn AL, Metcalfe TB, et al. Beliefs about medicines and adherence to asthma medications during pregnancy. J Asthma, 2023, 60(7): 1446-1454.
11.	Wang G, Murphy VE, Namazy J, et al. The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis. J Matern Fetal Neonatal Med, 2014, 27(9): 934-942.
12.	Murphy V, Namazy J, Powell H, et al. A meta-analysis of adverse perinatal outcomes in women with asthma: adverse perinatal outcomes in women with asthma. BJOG, 2011, 118(11): 1314-1323.
13.	Vyawahare A P, Gaidhane A, Wandile B. Asthma in pregnancy: a critical review of impact, management, and outcomes. Cureus, 2023, 15(12): e50094.
14.	Robijn AL, Harvey SM, Jensen ME, et al. Adverse neonatal outcomes in pregnant women with asthma: an updated systematic review and meta-analysis. Int J Gynaecol Obstet, 2024, 166(2): 596-606.
15.	Wang M, He W, Li M, et al. Maternal asthma and the risk of hypertensive disorders of pregnancy: a systematic review and meta-analysis of cohort studies. Hypertens Pregnancy, 2020, 39(1): 12-24.
16.	Grosso A, Locatelli F, Gini E, et al. The course of asthma during pregnancy in a recent, multicase-control study on respiratory health. Allergy Asthma Clin Immunol, 2018, 14: 16.
17.	Vatti RR, Teuber SS. Asthma and pregnancy. Clin Rev Allergy Immunol, 2012, 43(1): 45-56.
18.	Shebl E, Chakraborty R K. Asthma in pregnancy[M]//StatPearls. Treasure Island (FL): StatPearls Publishing, 2026.
19.	Bobrowski RA. Pulmonary physiology in pregnancy. Clin Obstet Gynecol, 2010, 53(2): 285-300.
20.	Teelucksingh S, Davis A, Nelson-Piercy C. Asthma and pregnancy: a narrative review. Chest, 2025: S0012-3692(25)05382-6.
21.	Popa M, Peltecu G, Gica N, et al. Asthma in Pregnancy. Review of Current Literature and Recommendations. Maedica, 2021, 16(1): 80-87.
22.	Kwah JH, Stevens WW. Asthma and allergies in pregnancy. Allergy Asthma Proc, 2019, 40(6): 414-417.
23.	Dumitru CS, Zara F, Novacescu D, et al. Pregnancy rhinitis: Pathophysiological mechanisms, diagnostic challenges, and management strategies-a narrative review. Life (Basel), 2025, 15(8): 1166.
24.	Balzano G, Fuschillo S, Melillo G, et al. Asthma and sex hormones. Allergy, 2001, 56(1): 13-20.
25.	Hellings PW, Vandekerckhove P, Claeys R, et al. Progesterone increases airway eosinophilia and hyper‐responsiveness in a murine model of allergic asthma. Clin Exp Allergy, 2003, 33(10): 1457-1463.
26.	LoMauro A, Aliverti A. Respiratory physiology of pregnancy: Physiology masterclass. Breathe, 2015, 11(4): 297-301.
27.	Pfaller B, José Yepes-Nu?ez J, Agache I, et al. Biologicals in atopic disease in pregnancy: an EAACI position paper. Allergy, 2021, 76(1): 71-89.
28.	Moldenhauer L M, Hull M L, Foyle K L, et al. Immune–metabolic interactions and T cell tolerance in pregnancy. J Immunol, 2022, 209(8): 1426-1436.
29.	Gouon-Evans V, Pollard J W. Eotaxin is required for eosinophil homing into the stroma of the pubertal and cycling uterus. Endocrinology, 2001, 142(10): 4515-4521.
30.	Zhao Y, Zhu Y, Chen X, et al. Circulating innate lymphoid cells exhibit distinctive distribution during normal pregnancy. Reprod Sci, 2022, 29(4): 1124-1135.
31.	López D A, Griffin A, Aguilar L M, et al. Prenatal inflammation remodels lung immunity and function by programming ILC2 hyperactivation. Cell Rep, 2024, 43(7): 114365.
32.	McDonald VM, Gibson PG. Treatable traits in asthma: moving beyond diagnostic labels. Med J Aust, 2022, 216(7): 331-333.
33.	Jameson JL, Longo DL. Precision medicine--personalized, problematic, and promising. N Engl J Med, 2015, 372(23): 2229-2234.
34.	Duszyk K, McDonald VM, Thomas D, et al. The treatable traits of asthma in pregnancy: A clinical audit. ERJ Open Res, 2024, 10(3): 00748-02023.
35.	Powell H, Murphy VE, Taylor DR, et al. Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial. The Lancet, 2011, 378(9795): 983-990.
36.	Murphy VE, Porsbjerg CM, Robijn A L, et al. Biomarker-guided management reduces exacerbations in non-eosinophilic asthma in pregnancy: A secondary analysis of a randomized controlled trial. Respirology, 2020, 25(7): 719-725.
37.	2025 GINA strategy report[EB/OL]. [2025-11-20]. https://ginasthma.org/2025-gina-strategy-report/.
38.	中華醫學會呼吸病學分會. 支氣管哮喘防治指南(2024年版). 中華結核和呼吸雜志, 2025, 48(3): 208-248.
39.	Schatz M, Dombrowski MP, Wise R, et al. The relationship of asthma medication use to perinatal outcomes. J Allergy Clin Immunol, 2004, 113(6): 1040-1045.
40.	Dombrowski MP. Asthma and pregnancy. Obstet Gynecol, 2006, 108(3 Part 1): 667-681.
41.	Schatz M, Dombrowski MP, Wise R, et al. Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol, 2006, 194(1): 120-126.
42.	Hegewald MJ, Crapo RO. Respiratory physiology in pregnancy. Clin Chest Med, 2011, 32(1): 1-13.
43.	Ma D, Cruz M J, Ojanguren I, et al. Risk factors for the development of bronchiectasis in patients with asthma. Sci Rep, 2021, 11(1): 22820.
44.	Weiss BM, Zemp L, Seifert B, et al. Outcome of pulmonary vascular disease in pregnancy: A systematic overview from 1978 through 1996. J Am Coll Cardiol, 1998, 31(7): 1650-1657.
45.	Bennett M, Chang C L, Tatley M, et al. The safety of cardioselective β₁ -blockers in asthma: literature review and search of global pharmacovigilance safety reports. ERJ Open Res, 2021, 7(1): 00801-02020.
46.	Hadid V, Patenaude V, Oddy L, et al. Sarcoidosis and pregnancy: Obstetrical and neonatal outcomes in a population-based cohort of 7 million births. J Perinat Med, 2015, 43(2): 201-207.
47.	Powell H, Murphy VE, Hensley MJ, et al. Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life. J Asthma, 2015, 52(10): 1023-1030.
48.	Tay TR, Radhakrishna N, Hore-Lacy F, et al. Comorbidities in difficult asthma are independent risk factors for frequent exacerbations, poor control and diminished quality of life. Respirology, 2016, 21(8): 1384-1390.
49.	Pfaller B, Bendien S, Ditisheim A, et al. Management of allergic diseases in pregnancy. Allergy, 2022, 77(3): 798-811.
50.	Malfertheiner M, Malfertheiner P, Costa S, et al. Extraesophageal symptoms of gastroesophageal reflux disease during pregnancy. Z Gastroenterol, 2015, 53(9): 1080-1083.
51.	Bidad K, Heidarnazhad H, Pourpak Z, et al. Gastroesophagial reflux disease and asthma in pregnant women with dyspnea. Iran J Allergy Asthma Immunol, 2014, 13(2): 104-109.
52.	Theodoropoulos DS, Lockey RF, Boyce HW, et al. Gastroesophageal reflux and asthma: a review of pathogenesis, diagnosis, and therapy. Allergy, 1999, 54(7): 651-661.
53.	Lai T, Wu M, Liu J, et al. Acid-suppressive drug use during pregnancy and the risk of childhood asthma: a meta-analysis. Pediatrics, 2018, 141(2): e20170889.
54.	Rogers L. Role of sleep apnea and gastroesophageal reflux in severe asthma. Immunol Allergy Clin North Am, 2016, 36(3): 461-471.
55.	Carnelio S, Morton A, McIntyre HD. Sleep disordered breathing in pregnancy: The maternal and fetal implications. J Obstet Gynaecol, 2017, 37(2): 170-178.
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1. Fuhlbrigge AL, Sharma S. Unraveling the heterogeneity of asthma: Decoding subtypes of asthma. J Allergy Clin Immunol, 2025, 156(1): 41-50.
2. Song WJ, Kang MG, Chang YS, et al. Epidemiology of adult asthma in asia: Toward a better understanding. Asia Pac Allergy, 2014, 4(2): 75-85.
3. Huang K, Yang T, Xu J, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet, 2019, 394(10196): 407-418.
4. Chapman KR, Boulet LP, Rea RM, et al. Suboptimal asthma control: Prevalence, detection and consequences in general practice. Eur Respir J, 2008, 31(2): 320-325.
5. 蘇楠, 林江濤, 劉國梁, 等. 我國8省市支氣管哮喘患者控制水平的流行病學調查. 中華內科雜志, 2014, 53(8): 601-606.
6. Kwon HL, Triche EW, Belanger K, et al. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am, 2006, 26(1): 29-62.
7. Li T, Dong F, Li N, et al. Maternal and perinatal outcomes of asthma exacerbation during pregnancy in a Chinese population: a retrospective cohort study. BMC Pulm Med, 2024, 24(1): 296.
8. Tamási L, Horváth I, Bohács A, et al. Asthma in pregnancy--immunological changes and clinical management. Respir Med, 2011, 105(2): 159-164.
9. Maselli DJ, Adams SG, Peters JI, et al. Management of asthma during pregnancy. Ther Adv Respir Dis, 2013, 7(2): 87-100.
10. Murphy VE, Robijn AL, Metcalfe TB, et al. Beliefs about medicines and adherence to asthma medications during pregnancy. J Asthma, 2023, 60(7): 1446-1454.
11. Wang G, Murphy VE, Namazy J, et al. The risk of maternal and placental complications in pregnant women with asthma: a systematic review and meta-analysis. J Matern Fetal Neonatal Med, 2014, 27(9): 934-942.
12. Murphy V, Namazy J, Powell H, et al. A meta-analysis of adverse perinatal outcomes in women with asthma: adverse perinatal outcomes in women with asthma. BJOG, 2011, 118(11): 1314-1323.
13. Vyawahare A P, Gaidhane A, Wandile B. Asthma in pregnancy: a critical review of impact, management, and outcomes. Cureus, 2023, 15(12): e50094.
14. Robijn AL, Harvey SM, Jensen ME, et al. Adverse neonatal outcomes in pregnant women with asthma: an updated systematic review and meta-analysis. Int J Gynaecol Obstet, 2024, 166(2): 596-606.
15. Wang M, He W, Li M, et al. Maternal asthma and the risk of hypertensive disorders of pregnancy: a systematic review and meta-analysis of cohort studies. Hypertens Pregnancy, 2020, 39(1): 12-24.
16. Grosso A, Locatelli F, Gini E, et al. The course of asthma during pregnancy in a recent, multicase-control study on respiratory health. Allergy Asthma Clin Immunol, 2018, 14: 16.
17. Vatti RR, Teuber SS. Asthma and pregnancy. Clin Rev Allergy Immunol, 2012, 43(1): 45-56.
18. Shebl E, Chakraborty R K. Asthma in pregnancy[M]//StatPearls. Treasure Island (FL): StatPearls Publishing, 2026.
19. Bobrowski RA. Pulmonary physiology in pregnancy. Clin Obstet Gynecol, 2010, 53(2): 285-300.
20. Teelucksingh S, Davis A, Nelson-Piercy C. Asthma and pregnancy: a narrative review. Chest, 2025: S0012-3692(25)05382-6.
21. Popa M, Peltecu G, Gica N, et al. Asthma in Pregnancy. Review of Current Literature and Recommendations. Maedica, 2021, 16(1): 80-87.
22. Kwah JH, Stevens WW. Asthma and allergies in pregnancy. Allergy Asthma Proc, 2019, 40(6): 414-417.
23. Dumitru CS, Zara F, Novacescu D, et al. Pregnancy rhinitis: Pathophysiological mechanisms, diagnostic challenges, and management strategies-a narrative review. Life (Basel), 2025, 15(8): 1166.
24. Balzano G, Fuschillo S, Melillo G, et al. Asthma and sex hormones. Allergy, 2001, 56(1): 13-20.
25. Hellings PW, Vandekerckhove P, Claeys R, et al. Progesterone increases airway eosinophilia and hyper‐responsiveness in a murine model of allergic asthma. Clin Exp Allergy, 2003, 33(10): 1457-1463.
26. LoMauro A, Aliverti A. Respiratory physiology of pregnancy: Physiology masterclass. Breathe, 2015, 11(4): 297-301.
27. Pfaller B, José Yepes-Nu?ez J, Agache I, et al. Biologicals in atopic disease in pregnancy: an EAACI position paper. Allergy, 2021, 76(1): 71-89.
28. Moldenhauer L M, Hull M L, Foyle K L, et al. Immune–metabolic interactions and T cell tolerance in pregnancy. J Immunol, 2022, 209(8): 1426-1436.
29. Gouon-Evans V, Pollard J W. Eotaxin is required for eosinophil homing into the stroma of the pubertal and cycling uterus. Endocrinology, 2001, 142(10): 4515-4521.
30. Zhao Y, Zhu Y, Chen X, et al. Circulating innate lymphoid cells exhibit distinctive distribution during normal pregnancy. Reprod Sci, 2022, 29(4): 1124-1135.
31. López D A, Griffin A, Aguilar L M, et al. Prenatal inflammation remodels lung immunity and function by programming ILC2 hyperactivation. Cell Rep, 2024, 43(7): 114365.
32. McDonald VM, Gibson PG. Treatable traits in asthma: moving beyond diagnostic labels. Med J Aust, 2022, 216(7): 331-333.
33. Jameson JL, Longo DL. Precision medicine--personalized, problematic, and promising. N Engl J Med, 2015, 372(23): 2229-2234.
34. Duszyk K, McDonald VM, Thomas D, et al. The treatable traits of asthma in pregnancy: A clinical audit. ERJ Open Res, 2024, 10(3): 00748-02023.
35. Powell H, Murphy VE, Taylor DR, et al. Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial. The Lancet, 2011, 378(9795): 983-990.
36. Murphy VE, Porsbjerg CM, Robijn A L, et al. Biomarker-guided management reduces exacerbations in non-eosinophilic asthma in pregnancy: A secondary analysis of a randomized controlled trial. Respirology, 2020, 25(7): 719-725.
37. 2025 GINA strategy report[EB/OL]. [2025-11-20]. https://ginasthma.org/2025-gina-strategy-report/.
38. 中華醫學會呼吸病學分會. 支氣管哮喘防治指南(2024年版). 中華結核和呼吸雜志, 2025, 48(3): 208-248.
39. Schatz M, Dombrowski MP, Wise R, et al. The relationship of asthma medication use to perinatal outcomes. J Allergy Clin Immunol, 2004, 113(6): 1040-1045.
40. Dombrowski MP. Asthma and pregnancy. Obstet Gynecol, 2006, 108(3 Part 1): 667-681.
41. Schatz M, Dombrowski MP, Wise R, et al. Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol, 2006, 194(1): 120-126.
42. Hegewald MJ, Crapo RO. Respiratory physiology in pregnancy. Clin Chest Med, 2011, 32(1): 1-13.
43. Ma D, Cruz M J, Ojanguren I, et al. Risk factors for the development of bronchiectasis in patients with asthma. Sci Rep, 2021, 11(1): 22820.
44. Weiss BM, Zemp L, Seifert B, et al. Outcome of pulmonary vascular disease in pregnancy: A systematic overview from 1978 through 1996. J Am Coll Cardiol, 1998, 31(7): 1650-1657.
45. Bennett M, Chang C L, Tatley M, et al. The safety of cardioselective β₁ -blockers in asthma: literature review and search of global pharmacovigilance safety reports. ERJ Open Res, 2021, 7(1): 00801-02020.
46. Hadid V, Patenaude V, Oddy L, et al. Sarcoidosis and pregnancy: Obstetrical and neonatal outcomes in a population-based cohort of 7 million births. J Perinat Med, 2015, 43(2): 201-207.
47. Powell H, Murphy VE, Hensley MJ, et al. Rhinitis in pregnant women with asthma is associated with poorer asthma control and quality of life. J Asthma, 2015, 52(10): 1023-1030.
48. Tay TR, Radhakrishna N, Hore-Lacy F, et al. Comorbidities in difficult asthma are independent risk factors for frequent exacerbations, poor control and diminished quality of life. Respirology, 2016, 21(8): 1384-1390.
49. Pfaller B, Bendien S, Ditisheim A, et al. Management of allergic diseases in pregnancy. Allergy, 2022, 77(3): 798-811.
50. Malfertheiner M, Malfertheiner P, Costa S, et al. Extraesophageal symptoms of gastroesophageal reflux disease during pregnancy. Z Gastroenterol, 2015, 53(9): 1080-1083.
51. Bidad K, Heidarnazhad H, Pourpak Z, et al. Gastroesophagial reflux disease and asthma in pregnant women with dyspnea. Iran J Allergy Asthma Immunol, 2014, 13(2): 104-109.
52. Theodoropoulos DS, Lockey RF, Boyce HW, et al. Gastroesophageal reflux and asthma: a review of pathogenesis, diagnosis, and therapy. Allergy, 1999, 54(7): 651-661.
53. Lai T, Wu M, Liu J, et al. Acid-suppressive drug use during pregnancy and the risk of childhood asthma: a meta-analysis. Pediatrics, 2018, 141(2): e20170889.
54. Rogers L. Role of sleep apnea and gastroesophageal reflux in severe asthma. Immunol Allergy Clin North Am, 2016, 36(3): 461-471.
55. Carnelio S, Morton A, McIntyre HD. Sleep disordered breathing in pregnancy: The maternal and fetal implications. J Obstet Gynaecol, 2017, 37(2): 170-178.
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