Asthma in Pregnancy

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What is the Prevalence of Asthma During Pregnancy?

The burden of asthma in pregnancy is increasing worldwide,1, 2 with European estimates of at least 4% of women having asthma,3 and at least 8% of women in antenatal clinics in the United Kingdom having asthma.4 Increases in asthma prevalence have also been reported in the United States1 from around 3% to more than 8% since 1994.2 In Australia the prevalence of asthma in pregnancy is 12%.5 As the most common respiratory disorder to complicate pregnancy, asthma represents a significant public

Changes in asthma affect both mother and baby

In addition to the effect of pregnancy on asthma, it has been well described that asthma affects a wide range of pregnancy outcomes, related to both the mother (Table 1) and the neonate (Table 2). However, there is conflicting evidence in the literature regarding these effects, possibly due to sizeable variation in study design, sample size, and confounding factors in each published report. Many of the studies reporting increased risk of perinatal complications with asthma have been large

Do Women Stop Using Asthma Medications While Pregnant?

There is a large body of evidence indicating that pregnant women reduce their use of asthma medications during pregnancy, against the advice of current guidelines or their physician.28, 56, 128, 129, 130 A 2003 survey of more than 500 women of child-bearing age who had asthma indicated that 82% of those who used ICS treatment were concerned about the effects of this medication on the fetus.131 Despite also having concerns for their own health about the consequences of discontinuing medication,

Effective treatment and management of pregnant women with asthma

Asthma that is well controlled in pregnancy is less likely to result in adverse outcomes than poorly controlled asthma. Consequently, during pregnancy regular medical review and monitoring of asthma is recommended, and a multidisciplinary approach may be most effective. The goals of management in pregnant women are to minimize asthma symptoms and limitations, prevent exacerbations, and maintain near normal lung function with minimal medication use, thereby ensuring maternal quality of life and

Summary

Asthma is a highly prevalent medical problem during pregnancy. Exacerbations of asthma or poorly controlled disease can increase the risk of adverse perinatal outcomes, which may influence future health. Well-controlled asthma during pregnancy is not considered to be a significant risk to the baby, and regular monitoring of maternal asthma throughout pregnancy is recommended. By controlling asthma and preventing severe exacerbation, ICS may provide protection against adverse outcomes.

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    Funding support: V.E.M. is funded by an Australian Research Training Fellowship (Part-Time) from the National Health and Medical Research Council.

    The authors have nothing to disclose.

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