By Nancy Deutsch
NEW YORK, May 29 (Reuters Health) - Pregnant women with asthma should
continue to take their regular asthma medication, and should be carefully
monitored throughout the pregnancy period by a physician, reports a joint
committee comprised of two physician groups.
"In general, (with asthmatics) it's safer to use medications during
pregnancy than not to use them," explained Dr. Mitchell Dombrowski, professor of
obstetrics and gynecology at Wayne State University in Detroit, and one of the
authors of the position paper in Annals of Allergy, Asthma and Immunology.
Asthma in pregnancy can lead to complications and even death, so controlling
asthma is paramount, he noted.
Initial recommendations on the use of medications for asthma and allergy in
pregnancy were issued by the National Asthma Education and Prevention Program in
1993. Since then, more research has been done in this area, and new asthma
medications have come on the market, creating a need for these new guidelines,
Dombrowski explained.
The position statement is a joint effort of the American College of Allergy,
Asthma and Immunology (ACAAI) and the American College of Obstetricians and
Gynecologists. The previous recommendations on the treatment of pregnant women
with asthma were that these women should continue to be medicated during
pregnancy.
"We reiterated that," Dombrowski told Reuters Health. However, "in the past,
the recommendation was to use inhaled beclomethasone. Now we're starting to say
if a woman is on another inhaled anti-inflammatory steroid, it is probably okay
to use that during pregnancy. The newer data is reassuring about drugs other
than beclomethasone."
Leukotriene inhibitors are the only drugs for which there is too little data
to make any recommendation--except to suggest they not be used during pregnancy
unless absolutely necessary until more studies confirm their safety, Dombrowski
said.
The authors of the position paper note that in addition to pharmacological
management, pregnant women with asthma should avoid asthma triggers such as
cigarette smoke and allergens. Furthermore, allergy shots can be continued
during pregnancy in patients without severe reactions to the shots, but a
pregnant woman who has never had an allergy shot should not start receiving
shots at this time.
According to ACAAI, almost 7% of pregnant women have asthma. More
information on care of asthma during pregnancy is available at
http://allergy.mcg.edu.
