Author ORCID Identifier
https://orcid.org/0000-0002-4969-6024
Abstract
Background: The well-established "One Airway, One Disease" concept recognizes the deep physiological and pathological connections between conditions affecting both the upper and lower respiratory tracts, most notably allergic rhinitis and asthma. During pregnancy, a woman's body undergoes significant immunological, hormonal, and physiological changes, which can profoundly influence and modulate existing or emerging airway inflammation.
Objective: This prospective observational study was designed with the primary objective of meticulously evaluating the correlation between upper and lower airway inflammation in pregnant women. We aimed to achieve this by assessing a range of clinical symptoms, objective functional parameters, and specific inflammatory markers.
Methods: We conducted an 18-month prospective observational study involving 150 pregnant women in their second and third trimesters, specifically between 14 and 36 weeks of gestation. These participants were recruited from a tertiary care academic hospital setting. For the purpose of analysis, the women were systematically grouped into three distinct categories: those diagnosed solely with allergic rhinitis (n=52), those with asthma as their only condition (n=46), and a third group presenting with both allergic rhinitis and asthma (n=52). Our comprehensive assessment battery included patient-reported clinical symptom scores (using the Nasal Symptom Score and Asthma Control Test), objective measures of respiratory function (spirometry and, in selected cases, rhinometry), and key inflammatory biomarkers such as fractional exhaled nitric oxide (FeNO) and serum eosinophil counts. Furthermore, a crucial follow-up evaluation was performed postpartum to observe any changes in their condition.
Results: Our analysis revealed significant and meaningful correlations among various parameters indicative of both upper and lower airway inflammation. Notably, patients who suffered from both asthma and allergic rhinitis exhibited statistically higher levels of FeNO and eosinophil counts, pointing to a greater inflammatory burden in this group. A strong positive correlation was consistently found between the severity of clinical symptom scores (r = 0.68, p < 0.001), indicating that worsening nasal symptoms were associated with poorer asthma control. Importantly, postpartum evaluations demonstrated a general and significant improvement in airway inflammation across the cohort.
Conclusion: The findings of this study provide robust support for the "One Airway, One Disease" hypothesis specifically within the context of pregnancy. This strong correlation underscores the critical importance of an integrated and holistic management approach for both upper and lower airway diseases, which is essential for optimizing the health and well-being of both the mother and the developing fetus.
Publication Date
2025
Publisher
JSS Academy of Higher Education & Research
Conflict of Interest
No conflicts of interest
Keywords
Allergic rhinitis, Asthma, Pregnancy, One Airway One Disease, Airway inflammation, Eosinophils, Asthma Control
Word Count
1870
Recommended Citation
K D, S Y.
One Airway, One Disease in Pregnancy: A Prospective Observational Study on the Correlation Between Upper and Lower Airway Inflammation in Pregnant Women.
Digital Journal of Clinical Medicine.
2025;
8(1):
-.
doi:
https://doi.org/10.55691/2582-3868.1249
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Cover Page Footnote
one airway one disease
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Comments
Much needed analysis as antenatal mothers can present with both upper and lower airway abnormalities which leads to frequent hospital visits