Uncontrolled asthma during pregnancy and lactation poses greater riskthan asthma medication

Uncontrolled asthma during pregnancy poses short and long-term risks to the mother and her baby, according to a recent study by Angelina Lim (DEPM PhD Candidate), Safeera Hussainy and Michael Abramson, published in Australian Prescriber (Vol.36:Iss.5; pp150-153).

Pregnant women tend to overestimate the risk of using asthma drugs, but they are often unaware of the greater risks of uncontrolled asthma. They put themselves at unnecessary risk of acute exacerbations by discontinuing or reducing therapy.

Maintaining optimal asthma control is crucial during pregnancy.

Inhaled short-acting beta agonists are safe to prescribe throughout pregnancy. Long-acting beta agonists need not be stopped in the first trimester and can be used in the second and third trimesters if needed to maintain adequate asthma control.

Inhaled corticosteroids, particularly budesonide, at recommended doses are safe to use during pregnancy and breastfeeding. Oral corticosteroids, at the doses used to treat asthma exacerbations, do not appear to pose a significant risk to the mother or child.

Women with asthma should be advised to continue to take their treatment while breastfeeding. Spacing the dose and feed time may be necessary when using oral corticosteroids.