Asthma in pregnancy - under-diagnosed and under-treated

Asthma is among the most common serious medical problems in pregnancy, and its prevalence may be increasing. Management is problematic because asthma may harm the fetus, yet little is known about fetal risks of asthma medications.

This study participants were a random sample of 3,609 mothers of nonmalformed infants born in Massachusetts between 1998 and 2006.

Physician-diagnosed asthma was present in 13.9% and possible asthma in an additional 16.0%.

Higher rates of asthma were observed among women who were younger, white, obese, and less well educated, had lower income, and smoked during pregnancy.

Medications:

- Leukotriene modifiers were used by only 3.4% of asthmatic women

- Inhaled steroid use increased from 19.0% during 1997-1999 to 23.3% in 2003-2005

- Use of inhaled beta(2)-agonists exceeded 50% in both periods

Less than 40% of women with poorly controlled asthma symptoms reported use of a controller medication.

High rates of asthma and asthma symptoms, together with the low rates of use of controller medications, underscore the need to better understand the risks and safety of asthma medications during pregnancy.

References:

Asthma in pregnancy and its pharmacologic treatment. Louik C, Schatz M, Hernández-Díaz S, Werler MM, Mitchell AA. Ann Allergy Asthma Immunol. 2010 Aug;105(2):110-7.

Women are more likely to be diagnosed with asthma and suffer greater morbidity than men. Medscape, 2011.
Asthma and pregnancy. JACI, 2011.
Asthma exacerbations during pregnancy can be reduced with a FENO-based treatment algorithm - number needed to treat was 6 (Lancet, 2011).

Image source: Woman at the ninth month of pregnancy. Wikipedia, GNU Free Documentation License.