1. Home>
2. Specialties>
3. Women's Health>
4. Summary and Comment

Continued Use of Asthma Medication During Pregnancy Keeps Wheezing at Bay

Asthma symptoms were more likely to remain stable during pregnancy when women continued with their usual therapies.

Asthma affects 8% to 9% of pregnant women; however, whether asthma's severity changes during pregnancy is unclear. A total of 641 asthmatic women who were recruited from community obstetricians and prenatal clinics were interviewed at gestational weeks 16, 20, 28, and 36 and postpartum. Based on their asthma symptoms and medication use, participants were classified according to Global Initiative for Asthma (GIA) categories as intermittent or mild, moderate, or severe persistent. Most women (58%) had intermittent asthma; 20% had mild persistent asthma, and 22% had moderate or severe persistent asthma.

None of the patient characteristics that were analyzed (e.g., age, body-mass index [BMI], parity) were significant risk factors for worsening asthma except that mild persistent asthmatics with BMI >26 kg/m² were at risk for their asthma to become at least moderate persistent (odds ratio, 1.3). Compared with women who had intermittent prepregnancy asthma, those who had mild persistent asthma were 50% more likely to experience severe asthma during pregnancy. Among women with moderate or severe asthma before pregnancy, risk for exacerbations rose almost threefold during pregnancy (OR, 2.8). Use of medications according to GIA guidelines was associated with 62% (among intermittent asthmatics) and 52% (among mild persistent asthmatics) lower risk for worsening asthma severity.

Comment: Many women discontinue their medications when they learn that they are pregnant. However, for asthmatic women, continuing their medications according to Global Initiative for Asthma guidelines lowers their risk for worsening symptoms during pregnancy. Inhaled steroids and bronchodilators have not been shown to compromise fetal safety. Providers who care for pregnant women should be familiar with the GIA guidelines, which stress that poorly controlled asthma presents risks to fetuses. Thus, women with asthma should use their medications consistently both before and during pregnancy.

— Wendy S. Biggs, MD

Published in Journal Watch Women's Health March 4, 2010

Citation(s):

Belanger K et al. Effect of pregnancy on maternal asthma symptoms and medication use. Obstet Gynecol 2010 Mar; 115:559.

• Medline abstract (Free)

Reader Remarks:

Review and add to remarks on this article

• Asthma, Buckwheat honey & Pregnancy
  Charles Beauchamp, retired from the VA, 11 Mar 2010 11:30 AM EST
  In my opinion it would be interesting to observe the adjuvant anti- inflammatory effect of adding Buckwheat honey to the... [more]

2011 Top Stories