USE of inhaled asthma medications throughout pregnancy was not found to be linked to adverse maternal and neonatal outcomes, new research has found. Asthma affects 5–13% of pregnant females, with many females requiring daily pharmacotherapy to achieve asthma control. Maternal asthma leaves pregnant females at increased risk for adverse perinatal outcomes, including preeclampsia, gestational diabetes, placental abruption, obstetric haemorrhage, and placenta previa, and the risk increases with asthma exacerbations. However, adherence to medication often decreases during pregnancy.
The study, conducted by researchers using linked population-based administrative databases from Alberta, Canada, aimed to understand the association between asthma medication use, asthma exacerbation, and maternal and neonatal outcomes. Pregnant females with asthma were categorised into groups based on their asthma medication use 1 year prior to pregnancy, including the use of short-acting β-agonists, inhaled corticosteroids (ICS), and ICS with long-acting β-agonists (ICS+LABA).
It was found that 38–60% of pregnant females discontinued either rescue or maintenance asthma medication, although the reason for discontinuation was unknown. The use of short-acting β-agonists, ICS, and ICS+LABA had greater odds of disease exacerbation compared to no asthma medication usage during pregnancy; however, researchers found that ICS use during pregnancy decreased the odds of preterm birth (adjusted odds ratio: 0.62; 95% confidence interval: 0.39–0.99) and neonatal intensive care unit admission (adjusted odds ratio: 0.66; 95% confidence interval: 0.45–0.97). The study also indicated that those with moderate-to-decreasing medication adherence and moderate-to-increasing adherence to ICS+LABA had greater odds of disease exacerbation compared to groups with low adherence.
The findings underscore the importance of continuing asthma maintenance medication during pregnancy to improve health outcomes for both mothers and neonates. Corresponding author Sangmin Sarah Lee said: “We found that women with asthma who continued to use inhaled corticosteroids during pregnancy had decreased odds of preterm delivery and infants who were admitted to the neonatal intensive care unit. We also showed no evidence of adverse pregnancy, maternal, and neonatal outcomes with the use of rescue or maintenance asthma medication during pregnancy.”
References
Lee S et al. Impact of asthma medications during pregnancy on asthma exacerbation, maternal, and neonatal outcomes. J Allergy Clin Immunol Pract. 2024;DOI:10.1016/j.jaip.2024.02.017.
