Most asthma drugs OK to use during pregnancy
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With the exception of steroid pills, asthma medications taken during pregnancy do not appear to impair the growth of the unborn baby, researchers in California report.
“These data are reassuring for clinicians from the standpoint of adhering to treatment guidelines and provide appropriate treatment of asthma for women who are pregnant with respect to fetal growth,” said Dr. Christina D. Chambers from UCSD Medical Center, San Diego.
Chambers and her associates compared various measures of fetal growth in 551 women with asthma who used inhaled steroids or systemic (oral) steroids with 103 similar women who used only bronchodilator inhalers and with 303 “controls” without asthma.
Infants of women who took systemic steroids were, on average, nearly 200 grams lighter than the infants of women in the other groups, the investigators report in the Journal of Allergy and Clinical Immunology.
Birth weights and lengths of infants of mothers in the other three groups did not differ significantly, the results indicate. Average head circumferences and the rates of small-for-gestational-age (SGA) also did not differ significantly among the groups, the researchers note.
SGA rates were, however, higher among users of higher doses of oral steroids than among users of lower doses, the report indicates.
“The optimum strategy for women of reproductive age with chronic diseases is to discuss treatment regimens prior to pregnancy and to plan pregnancies with their diseases under the best possible control prior to conception,” Chambers advised.
“Inhaled corticosteroids are still the best treatment to control asthma and do not seem to significantly impair fetal growth,” write Dr. Catherine Lemiere and Dr. Lucie Blais from University of Montreal in a related editorial.
“However,” they caution, “before ruling out with confidence any potential adverse effect of inhaled corticosteroids on fetal growth, there is a need for larger studies adequately powered to answer this question.”
SOURCE: Journal of Allergy and Clinical Immunology, September 2005.
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