Linda Long | PubMed Health

PubMed2004

Use of inhaled steroids by pregnant asthmatic women does not reduce intrauterine growth.

BACKGROUND: Inhaled steroids are recommended for the treatment of persistent asthma during pregnancy, but their potential effects on intrauterine growth have been inadequately evaluated. OBJECTIVE: The purpose of this study was to evaluate the association between maternal use of specific inhaled steroids and inhaled steroid dose during pregnancy and the incidence of infants who are small for gestational age (SGA) and mean birth weight. METHODS: Pregnant asthmatic women being treated with inhaled steroids were enrolled in the study before delivery by their managing allergists. Information regarding the specific inhaled steroid and daily dose used, requirement for oral steroids, occurrence of acute asthmatic episodes, maternal race, birth weight, gestational age, and congenital malformations was obtained for each patient. SGA was defined through use of a published normative sample of American births. RESULTS: A total of 474 women were enrolled in the study; of the 451 enrolled participants whose pregnancy ended in a singleton live birth, 396 (88%) completed the study. The incidence of infants with low birth weight, preterm births, and congenital malformations in this cohort was not greater than expected in the general population. The incidence of SGA was 7.1% (95% CI, 5.0% to 10.1%). No significant relationships between specific inhaled steroid or dose of inhaled steroid used and either SGA or mean birth weight were observed. CONCLUSION: These data suggest that the use of inhaled steroids by pregnant asthmatic women does not reduce intrauterine growth and supports the recommendation that inhaled steroids should be used in the management of persistent asthma during pregnancy.

Administration, Inhalation↗

PubMed2002

Variables affecting asthma course during pregnancy.

BACKGROUND: The course of asthma is frequently altered by pregnancy, but the mechanisms remain undefined. OBJECTIVE: The purpose of this study was to identify specific maternal or pregnancy characteristics that are related to the course of asthma during pregnancy. METHODS: A secondary analysis of a previous prospective study identified 568 pregnant women whose patient-reported asthma course during pregnancy was compared with the women's usual disease course. Potential explanatory variables were compared between groups defined by their pregnancy versus usual course (better, worse, same). RESULTS: Improvement of asthma during pregnancy was noted in 33.6%, worsening was reported in 36.3%, no change was reported in 26.4%, and the course was uncertain in 3.7%. There was a significant concordance between asthma course and course of rhinitis during pregnancy. Rhinitis improved in 51.1% of patients whose asthma improved during pregnancy and worsened in 19.8% of these women. Rhinitis worsened in 55.9% of patients whose asthma worsened during pregnancy and improved in 2.1% of these women. No significant relationships were found between gestational asthma course and maternal demographic factors, panic-fear score, smoking, maternal weight, infant birth weight, or infant sex. CONCLUSIONS: The relationship of gestational asthma course to rhinitis symptoms may have clinical and mechanistic significance. Further studies will be necessary to test this hypothesis.

Adult↗