The effect of pregnancy on asthma varies; deterioration is slightly more common than improvement, but most pregnant women do not have severe attacks.
The effect of asthma on pregnancy also varies, but severe, poorly controlled asthma increases risk of (1)
Maternal morbidity and mortality
Also, cesarean delivery is required more often in patients with asthma.
Загальне посилання
1. Abdullah K, Zhu J, Gershon A, Dell S, To T: Effect of asthma exacerbation during pregnancy in women with asthma: a population-based cohort study. Eur Respir J 55(2):1901335, 2020. doi:10.1183/13993003.01335-2019
Treatment of Asthma in Pregnancy
Inhaled bronchodilators and corticosteroids
For an acute exacerbation, addition of IV methylprednisolone, followed by oral prednisone
Pregnancy does not usually change treatment of asthma (1). Women are taught strategies to help manage asthma, including how to minimize exposure to triggers and how to serially measure pulmonary function (usually with a handheld peak flow meter).
Inhaled bronchodilators and corticosteroids are first-line maintenance therapy for asthma in pregnant women. Budesonide is the preferred inhaled corticosteroid. Based on available data, inhaled budesonide does not appear to increase the risk of congenital malformations in humans (2).
For an acute exacerbation, in addition to bronchodilators, methylprednisolone 60 mg IV every 6 hours for 24 to 48 hours may be used, followed by oral prednisone in a tapering dose. Women who are currently receiving or have recently required systemic corticosteroids should receive intravenous corticosteroids during labor and for 24 hours after delivery to prevent adrenal crisis.
Довідкові матеріали щодо лікування
1. Bonham CA, Patterson KC, Strek ME: Asthma outcomes and management during pregnancy. Chest 153(2):515-527, 2018. doi:10.1016/j.chest.2017.08.029
2. Källén B, Rydhstroem H, Aberg A: Congenital malformations after the use of inhaled budesonide in early pregnancy. Obstet Gynecol 93(3):392-395, 1999.
