Asthma Medicine in Pregnancy Tied to Small Rise in Risk of Congenital Anomalies

By Reuters Staff

August 10, 2015

NEW YORK (Reuters Health) - The use of beta2-agonists and inhaled corticosteroids for asthma during pregnancy is associated with an increased risk of a few specific congenital anomalies, according to a European study.

Maternal asthma and its exacerbations are associated with an increase in the overall risk of congenital anomalies, and earlier studies suggested an increased risk of certain anomalies after first-trimester exposure to asthma medications.

Dr. Ester Garne from Hospital Lillebaelt Kolding in Kolding, Denmark, and colleagues used data from 13 European population-based congenital anomaly registries to investigate the risk of specific congenital anomalies in relation to specific antiasthma medications.

The use of inhaled beta2-agonists in the first trimester was associated with an increased risk of cleft palate and gastroschisis, and the combination of beta2-agonists and inhaled corticosteroids was associated with an increased risk of renal dysplasia.

Inhaled corticosteroids alone did not appear to be associated with a significant increase in the risk of congenital anomalies, the researchers report in the Journal of Allergy and Clinical Immunology, online July 26.

"Although we have found increased odds of cleft palate and gastroschisis after exposure to beta2-agonists, the excess risk for the individual woman is low," they note. "The nonchromosomal prevalence of these 2 congenital anomalies in the EUROCAT registries is 8 to 9 per 10,000 births. Even with a 5-fold increased risk, the risk for the individual pregnancy is still less than 1 in 100. This is very important because the risks of uncontrolled asthma might be much greater than these specific risks."

"Use of prophylactic inhaled steroids seems to be the best solution for treatment of asthma in pregnancy to prevent asthma exacerbations and to reduce the need for beta2-agonists," the authors conclude.

The study has no commercial funding.

Dr. Garne did not respond to a request for comments.

SOURCE: http://bit.ly/1Ir2Pju

J Allergy Clin Immunol 2015.

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