New treatment guidelines for pregnant women w...( regnant women with asthma should have t...)

New treatment guidelines for pregnant women with asthma

regnant women with asthma should have this medication available at all times.

Women who have symptoms at least two days a week or two nights a month have persistent asthma and need daily medication for long-term care of their asthma and to prevent exacerbations. Inhaled corticosteroids are the preferred medication to control the underlying inflammation in pregnant women with persistent asthma. The guidelines note that there are more data on the safety of budesonide use during pregnancy than on other inhaled corticosteroids; however, there are no data indicating that other inhaled corticosteroids are unsafe during pregnancy, and other inhaled corticosteroids may be continued if they effectively control a patient's asthma. Alternative daily medications are leukotriene receptor antagonists, cromolyn, or theophylline.

For patients whose persistent asthma is not well controlled on low doses of inhaled corticosteroids alone, the guidelines recommend either increasing the dose of inhaled corticosteroid or adding another medication -- a long-acting beta agonist. The expert panel concluded that data are insufficient to indicate a preference of one option over the other.

Oral corticosteroids may be required for the treatment of severe asthma. The guidelines note that there are conflicting data regarding the safety of oral corticiosteroids during pregnancy; however, severe, uncontrolled asthma poses a definite risk to the mother and fetus; and use of oral corticosteroids may be warranted.

"Several studies have shown that taking inhaled corticosteroids improves lung function during pregnancy and reduces asthma exacerbations--and other large, prospective studies found no relation between taking inhaled corticosteroids and congenital abnormalities or other adverse pregnancy outcomes," said Michael Schatz, M.D., M.S., chief of the Department of Allergy for Kaiser Permanente San Diego Medical Center. Schatz is also a member of
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Contact: NHLBI Communications Office
nhlbi_news@nhlbi.nih.gov
301-496-4236
NIH/National Heart, Lung, and Blood Institute
11-Jan-2005

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