Asthma and Pregnancy

December 14, 2007

Q & A: Are drugs for asthma safe in pregnancy?

The developing baby won't do very well if the expectant mother doesn't do well. Asthma is an illness that can be mild but can also be so severe to be life-threatening. Pregnancy, of course, is an additional physiologic challenge that could impact the severity of asthma. I would recommend that you go with your obstetrician's advice on this, as he or she has probably had a lot of experience with pregnancy and asthma in training.

As far as cleft palates and other deformities in animal studies, the first thing you have to remember is that you cannot translate the risk to animals to the risk in humans. We compare them anyway, though, because ANY information is better than no information. And asthma medicines are not the only drugs with these warnings. Every day I and all other obstetricians use medicines that have some potential risk to them. Luckily, these unlikely risks are usually never encountered. As with any choice in medicine, the bottom line is: RISK vs. BENEFIT. And you've got to take care of Mom first, otherwise baby will suffer, too. Treat your asthma and allow your doctor to choose the drugs wherein the benefits outweigh the risks. You're not going to find a completely risk-free medicine--not even Tylenol (which I recommend all the time). But remember that the risks from undertreated asthma are much worse for the baby than any of the drugs used to treat it.

Asthma and Pregnancy

For the record, in my practice, asthma and pregnancy have enjoyed a fairly harmless tradition. Perhaps this is because I treat the mother first, allowing the baby to bask in the protection of good maternal health.

An added note: In pregnancy your immune system is somewhat blunted, otherwise you might reject the baby; but this means also that little upper respiratory infections may become worse, especially with asthma history. In my practice, I'm fairly liberal with antibiotics in pregnant asthma patients who have upper respiratory infections.

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