Asthma Management Critical During Pregnancy

Associated with a host of maternal and fetal complications, asthma worsens in about 40% of pregnant women, according to a review article published in Allergy and Asthma Proceedings.

“Evaluation of asthma control during pregnancy is critical, and it should be assessed by spirometry and validated questionnaires in prenatal visits,” wrote corresponding author Sergio E. Chiarella, MD, of the Mayo Clinic Division of Allergic Diseases, Rochester, Minnesota, and study coauthors.

The Global Initiative for Asthma recommends clinicians assess asthma control by asking about the frequency of asthma symptoms, the need for short-acting inhaled therapy, and the time of symptoms. Numerical questionnaires such as the Asthma Control Test have been validated for use in pregnant women, the article explained.

The review article summarizes therapeutic options, which are like those for women who are not pregnant and include inhaled corticosteroids, leukotriene receptor antagonists, short- and long-acting beta-₂ agonists, inhaled muscarinic antagonists, and biologics.

“Importantly, cornerstones of the pharmacotherapy of asthma seem to be safe during pregnancy,” the authors wrote.

Potential roadblocks to adequate management of asthma in pregnant women include nonadherence to medication, lack of education, and smoking habits. The review mentions a retrospective study that found pregnant women with asthma tended to reduce asthma therapy during gestation. As a result, exacerbations increased.

“Clinicians need to adequately assess concerns about asthma management and perceptions of disease course to ensure proper adherence,” the authors advised.

Reference

Bravo-Solarte DC, Garcia-Guaqueta DP, Chiarella SE. Asthma in pregnancy. Allergy Asthma Proc. 2023;44(1):24-34. doi:10.2500/aap.2023.44.220077