The acceptability and feasibility of implementing a fractional exhaled nitric oxide (FeNO)-based asthma management strategy into antenatal care: the perspective of pregnant women with asthma

The prevalence of asthma in pregnancy has increased in the US from 5.5% in 2001 to 7.8% in 2007 (Hansen et al., 2013) with the most recently reported prevalence in 2019 of 9.1% (Cohen et al., 2019). Sweden has a prevalence of 9.4% (Reino et al., 2014). In Australia, asthma is the most common chronic condition during pregnancy, complicating 12.7% of pregnancies (Sawicki et al., 2012). The increased risk of adverse maternal (gestational diabetes [RR 1.39, 95% CI 1.17, 1.66]; hypertension and pre-eclampsia [RR 1.54, 95% CI 1.32-1.81]) and fetal outcomes (low birth weight [RR 1.46, 95% CI 1.22-1.75]; premature birth [RR 1.41, 95% CI 1.22-1.61]) with maternal asthma is well documented (Murphy et al., 2011; Namazy et al., 2012; Murphy et al., 2013; Wang et al., 2014). Adverse outcomes are further increased if the woman experiences exacerbation of her asthma symptoms during pregnancy (Namazy et al., 2013; Wang et al., 2014). Thus, optimising asthma control and minimising exacerbations is the goal of antenatal asthma management.