How is asthma managed during pregnancy?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Asthma complicates 4-8% of pregnancies. Mild and well-controlled moderate asthma can be associated with excellent maternal and perinatal pregnancy outcomes. Severe and poorly controlled asthma may be associated with increased prematurity and other perinatal complications, to include maternal morbidity and mortality. Optimal management of asthma during pregnancy includes objective monitoring of lung function, avoiding or controlling asthma triggers, patient education, and individualized pharmacologic therapy. Inhaled corticosteroids are the preferred medication for all levels of persistent asthma during pregnancy. For pregnant women with asthma, it is safer to be treated with asthma medications than to have asthma symptoms and exacerbations. The ultimate goal of asthma therapy is to maintain adequate oxygenation of the fetus by prevention of hypoxic episodes in the mother.

With the exception of alpha-adrenergic compounds other than pseudoephedrine and some antihistamines, most drugs used to treat asthma and allergic rhinitis have not been shown to increase any risk to the mother or fetus. The National Institute of Health stated that albuterol (Proventil HFA), beclomethasone (QVAR), budesonide (Pulmicort Flexhaler or Respules), prednisone (Deltasone, Orasone), and theophylline, when clinically indicated, are considered appropriate for the treatment of asthma in pregnancy.

The American College of Obstetrics and Gynecology issued updated clinical guidelines for 2008. [53] Poorly controlled asthma can result in low birth weight, increased prematurity, and increased perinatal mortality.


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