Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better

Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better

Asthma is a common medical condition complicating pregnancy with potentially serious effects on pregnancy outcome. The aim of this review is to provide an update on efficacy and safety of asthma medications, primarily bronchodilators and corticosteroids, used during pregnancy with focus on pregnancy...

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Main Authors: Gregersen, Thorbjørn Lomholt, Ulrik, Charlotte Suppli
Format: Online
Language:English
Published: Dove Medical Press 2013
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833838/
id pubmed-3833838
recordtype oai_dc
spelling pubmed-38338382013-11-20 Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better Gregersen, Thorbjørn Lomholt Ulrik, Charlotte Suppli Review Asthma is a common medical condition complicating pregnancy with potentially serious effects on pregnancy outcome. The aim of this review is to provide an update on efficacy and safety of asthma medications, primarily bronchodilators and corticosteroids, used during pregnancy with focus on pregnancy outcome, and, furthermore, to discuss limitations of available studies and point to possible improvements in future studies. A planned series of systematic searches was conducted using the PubMed database. Use of short-acting β2-agonists has generally been established as safe, and the few studies stating otherwise appear to have, perhaps critical, methodological limitations. The safety of long-acting β2-agonists remains to be further investigated, and the few available studies have methodological limitations and, therefore, provide no definite answers, although a very recent study supports the safety of add-on long-acting β2-agonists to inhaled corticosteroids. Inhaled corticosteroids are generally found to be safe, although further research is needed to investigate both the efficacy and safety of high dose therapy with inhaled corticosteroids. Studies have reported associations between the use of systemic corticosteroids and adverse perinatal outcomes, such as preterm birth, low birth weight, and pre-eclampsia. This must, however, be weighed against the potential serious impact of severe, uncontrolled asthma itself on pregnancy outcome. The main obstacle to a valid interpretation of several of the available studies is the inadequate stratification for asthma severity and control. Overall, asthma in itself and not just poor asthma control poses a greater risk to pregnancy outcomes than asthma medication. Nonetheless, more studies focusing on disentangling the effects of asthma alone and asthma medications are needed. Increased use of stratified risk assessments, taking the concept of asthma severity into greater consideration, is much warranted in future studies. Dove Medical Press 2013-11-15 /pmc/articles/PMC3833838/ /pubmed/24259987 http://dx.doi.org/10.2147/JAA.S52592 Text en © 2013 Gregersen and Urlik. This work is published by Dove Medical Press Ltd, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Ltd, provided the work is properly attributed.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Gregersen, Thorbjørn Lomholt
Ulrik, Charlotte Suppli
spellingShingle Gregersen, Thorbjørn Lomholt
Ulrik, Charlotte Suppli
Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
author_facet Gregersen, Thorbjørn Lomholt
Ulrik, Charlotte Suppli
author_sort Gregersen, Thorbjørn Lomholt
title Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
title_short Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
title_full Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
title_fullStr Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
title_full_unstemmed Safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
title_sort safety of bronchodilators and corticosteroids for asthma during pregnancy: what we know and what we need to do better
description Asthma is a common medical condition complicating pregnancy with potentially serious effects on pregnancy outcome. The aim of this review is to provide an update on efficacy and safety of asthma medications, primarily bronchodilators and corticosteroids, used during pregnancy with focus on pregnancy outcome, and, furthermore, to discuss limitations of available studies and point to possible improvements in future studies. A planned series of systematic searches was conducted using the PubMed database. Use of short-acting β2-agonists has generally been established as safe, and the few studies stating otherwise appear to have, perhaps critical, methodological limitations. The safety of long-acting β2-agonists remains to be further investigated, and the few available studies have methodological limitations and, therefore, provide no definite answers, although a very recent study supports the safety of add-on long-acting β2-agonists to inhaled corticosteroids. Inhaled corticosteroids are generally found to be safe, although further research is needed to investigate both the efficacy and safety of high dose therapy with inhaled corticosteroids. Studies have reported associations between the use of systemic corticosteroids and adverse perinatal outcomes, such as preterm birth, low birth weight, and pre-eclampsia. This must, however, be weighed against the potential serious impact of severe, uncontrolled asthma itself on pregnancy outcome. The main obstacle to a valid interpretation of several of the available studies is the inadequate stratification for asthma severity and control. Overall, asthma in itself and not just poor asthma control poses a greater risk to pregnancy outcomes than asthma medication. Nonetheless, more studies focusing on disentangling the effects of asthma alone and asthma medications are needed. Increased use of stratified risk assessments, taking the concept of asthma severity into greater consideration, is much warranted in future studies.
publisher Dove Medical Press
publishDate 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833838/
_version_ 1612028636074868736

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