Asthma during pregnancy: how obstetricians regard asthmatic patients' treatment

Asthma is the most common pulmonary condition encountered during pregnancy. Based on our clinical experience as a pulmonologist and an internal medicine specialist, we frequently manage pregnant women with asthma, often without prior referral from an obstetrician. This study aimed to evaluate obstetricians' clinical approaches to asthma management during pregnancy using a structured questionnaire.

A 12-item questionnaire was developed and distributed electronically to obstetricians nationwide. Participation was voluntary, and respondents were assured of full anonymity. The survey was administered via e-mail through a secure online platform.

Among the participants, 26 (61.9%) were specialists, while 16 (38.1%) held academic titles as associate professors or professors. Regarding consultation practices, 23 obstetricians (54.8%) reported consistently consulting a pulmonologist from the early stages of pregnancy, 10 (23.8%) did so frequently, 8 (19.0%) occasionally, and 1 (2.4%) stated that they never sought consultation. In terms of delivery preferences for asthmatic patients, 32 respondents (76.2%) favored vaginal delivery, while 10 (23.8%) preferred cesarean section. Among those who opted for cesarean delivery, 41 (97.6%) reported a preference for regional anesthesia, and only 1 (2.4%) indicated the use of general anesthesia.

Asthmatic pregnant patients should be reassured both by obstetricians and by the pulmonologists or internists involved in their care that the majority of medications used in asthma management are classified as Category B and are generally considered safe during pregnancy. Physicians should remain aware of their dual responsibility, both ethical and legal, when making therapeutic decisions during this sensitive period.

This study was registered by the scientific board of Fatih Sultan Mehmet Education and Research Hospital (FSM EAH-KAEK 2023/71).