Control of asthma critical during pregnancy
Jan. 11, 2005
WASHINGTON (AP) -
Physicians should pay close attention to managing asthma in
pregnant patients, according to guidelines being released by the National Asthma
Education and Prevention Program.
Asthma can lead to serious medical problems, both for mothers-to-be and their
fetuses, the program warned. "Simply put, when a pregnant patient has trouble
breathing, her fetus also has trouble getting the oxygen it needs," Dr. William
Busse, professor of medicine at the University of Wisconsin Medical School and
chairman of the panel that developed the guidelines, said in a statement.
Dr. Barbara Alving, the institute's acting director, said "the guidelines
review the evidence on asthma medications used by pregnant patients. The
evidence is reassuring, and suggests that it is safer to take medications than
to have asthma exacerbations."
The guidelines, being published this week in the Journal of Allergy and
Clinical Immunology, urge limiting exposure to asthma triggers and treating
conditions that can worsen the respiratory ailment, such as allergic rhinitis,
sinusitis and acid reflux.
"As important as medications are for controlling asthma, a pregnant woman can
reduce how much medication is needed by identifying and avoiding the factors
that make her asthma worse, such as tobacco smoke or allergens like dust mites,"
Dr. Michael Schatz, chief of the Department of Allergy at Kaiser Permanente San
Diego Medical Center, said in a statement.
For about 30 per cent of women who have mild asthma when they get pregnant,
the illness worsens during pregnancy, according to a recent study by the
National Institute of Child Health and Human Development. On the other hand, the
study also found that asthma improved in 23 per cent of the women who initially
had moderate or severe asthma.
Among the recommendations of the guidelines:
-Albuterol, a short-acting inhaled drug, can be used as a quick-relief
medication to treat asthma symptoms. Pregnant women with asthma should have this
medication available at all times.
-For women with persistent asthma, inhaled corticosteroids are the preferred
medication to control the underlying inflammation.
-For women whose persistent asthma is not well-controlled on low doses of
inhaled corticosteroids alone, the guidelines recommend either increasing the
dose or adding another medication - called a long-acting beta agonist.
-Oral corticosteroids may be required for the treatment of severe asthma. The
guidelines note that there are conflicting data regarding the safety of oral
corticosteroids during pregnancy, but add that severe, uncontrolled asthma poses
a definite risk to both mother and fetus.