The safety of inhaled β-agonist bronchodilators during pregnancy

Schätz, Michael; Zeiger, Robert S.; Harden, Kathleen M.; Hoffman, Clement P.; Forsythe, Alan B.; Chilingar, Linda; Porreco, Richard P.; Benenson, Abram S.; Sperling, William; Saunders, Brian S.; Kagnoff, Marcia

doi:10.1016/0091-6749(88)90984-0

Cited by 108 publications

(60 citation statements)

References 15 publications

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“…For most medications used to treat asthma there is little evidence to suggest an increased risk to the fetus [378]. A good patient-healthcare professional relationship, along with independent printed material, such as the statement from the National Asthma Education and Prevention Program (USA) on the treatment of asthma during pregnancy [379], will provide important additional reassurance [380,381].…”

Section: Pregnancymentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,638

2,301

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Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

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Section: Pregnancymentioning

confidence: 99%

Global strategy for asthma management and prevention: GINA executive summary

Bateman

Ss²,

Barnes³

et al. 2008

European Respiratory Journal

2,638

2,301

View full text Add to dashboard Cite

show abstract

“…There is extensive evidence for the safety of the major drug classes used to treat asthma during pregnancy, including short-acting b 2 -agonists [137,138], theophylline [58,138] and ICS [19,50,138]. The safety of oral steroids for asthma during pregnancy is less clear, as two large prospective cohort studies recently found an association between oral steroid use and an increased risk of pre-term delivery [31,33].…”

Section: The Treatment and Management Of Asthma During Pregnancymentioning

confidence: 99%

Asthma during pregnancy: mechanisms and treatment implications

Murphy

Gibson²,

Smith³

et al. 2005

European Respiratory Journal

155

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Asthma is becoming increasingly prevalent worldwide. Numerous historical and prospective cohort studies have investigated the effects of maternal asthma on pregnancy outcome; however, the data has been conflicting and many studies have not used standard classifications for asthma severity. Overall, the literature suggests that asthmatic females are more at risk of low birth weight neonates, pre-term delivery and complications such as preeclampsia, especially in the absence of actively managed asthma treated with inhaled corticosteroids. Pregnancy with a female foetus may particularly increase the risk of these outcomes.In addition, pregnancy has an effect on the course of asthma. The risk of an exacerbation requiring medical intervention may be as high as 50% in females with severe asthma and this may further increase the risk of poor outcomes, particularly low birth weight and pre-term delivery.The mechanisms responsible for changes in asthma with pregnancy, or alterations in pregnancy outcomes due to asthma have not been thoroughly explored. Maternal inflammatory pathways may contribute to reduced foetal growth through alterations in placental function.Asthma treatment, by reducing maternal inflammation and preventing exacerbations, is safe for use in pregnant females and contributes to improved outcomes for both mother and foetus.

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“…11,12 On the other hand, systemic corticosteroids have been associated with preterm delivery, pre-eclampsia, gestational diabetes, congenital anomalies, and reduced birth weight. [12][13][14][15] Because oral glucocorticoids inhibit both growth hormone and insulin-like growth factor 1 and also negatively affect collagen synthesis, 16 concern has been raised regarding the potential of inhaled corticosteroids (ICSs) to impede fetal growth.…”

mentioning

confidence: 99%