Asthma is common in pregnant women and there are well-known risks particularly among females with moderate-to-severe asthma and exacerbations during pregnancy:
- low birth weight and small for gestational age,
- preterm birth, especially with oral steroid use
- a small but statistically significant increased risk of congenital malformations, particularly of cleft lip with or without cleft palate
- an increased risk of neonatal hospitalisation and death
Active management may reduce these risks, possibly through reductions in exacerbations.
Viral infections are an important trigger of asthma exacerbations in pregnancy. In the vast majority of cases, benefits outweigh the risks of indicated asthma medication use in pregnancy. Poor medication adherence despite worsening asthma symptoms in pregnancy is a problem.
Improving asthma control in pregnancy has the potential to improve not only the mother’s health but also that of her child.
Budesonide (trade name Pulmicort) is the only category B inhaled steroid (see the diagram below). Montelukast is also category B.
Asthma Inhalers (click to enlarge the image).
How to treat allergies and asthma during pregnancy - ACAAI video:
The former ACAAI president, Dr. Fineman, is shown in the video above. See Dr. Fineman's WAO TV interview on another important and related topic: Asthma adherence: how can we help our patients do it better?
Asthma in pregnancy: a hit for two. Vanessa E. Murphy et al. Eur Respir Rev March 1, 2014 vol. 23 no. 131 64-68 (full text).
Image source: Wikipedia, GNU Free Documentation License.