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[Pharmacological treatment of asthma during pregnancy]

S A van Nederveen-Bendien1, S R J van Oord-Bosselaar, A H Feitsma

  • 1HagaZiekenhuis, Den Haag.

Nederlands Tijdschrift Voor Geneeskunde
|March 10, 2018
PubMed

Insights

Asthma in pregnancy increases risks for preterm birth and low birth weight. However, using asthma medications like inhaled corticosteroids (ICS) and bronchodilators during pregnancy is generally safe and recommended for better outcomes.

Area of Science:

  • Obstetrics and Gynecology
  • Pulmonology
  • Pharmacology

Background:

  • Asthma during pregnancy is linked to adverse outcomes like preterm delivery, low birth weight, and pre-eclampsia.
  • Concerns regarding the teratogenic effects of asthma medications contribute to undertreatment among healthcare professionals and pregnant individuals.
  • Existing data suggests a low risk of teratogenic effects from commonly used inhaled asthma medications.

Purpose of the Study:

  • To evaluate the risks associated with asthma during pregnancy.
  • To assess the safety and efficacy of asthma pharmacotherapy in pregnant individuals.
  • To provide recommendations for the management of asthma in pregnant women.

Main Methods:

  • Review of existing literature on asthma in pregnancy.
  • Analysis of teratogenic risk data for inhaled corticosteroids (ICS), short-acting beta-agonists (SABA), and long-acting beta-agonists (LABA).
  • Comparison of outcomes between well-controlled asthma and uncontrolled asthma during pregnancy.

Main Results:

  • Asthma in pregnancy is associated with increased risks of preterm delivery, low birth weight, and pre-eclampsia.
  • Inhaled asthma medications (ICS, SABA, LABA) have a small risk of teratogenic effects and have been used safely by many patients.
  • Well-controlled asthma during pregnancy via pharmacological therapy is safer than managing asthma symptoms and exacerbations.

Conclusions:

  • Managing asthma effectively with medication during pregnancy is crucial for reducing maternal and fetal complications.
  • The benefits of controlled asthma outweigh the minimal risks associated with prescribed inhaled asthma medications.
  • Preconception counseling and ongoing management are recommended for pregnant women with asthma.

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