Nov 1 (Reuters) – Almost a third of women on asthma
medications stop using them during the first few months of
pregnancy, despite advice that a mother’s uncontrolled asthma is
more dangerous to the developing fetus than the drugs, according
to a study from the Netherlands.
A lack of oxygen during development, known as hypoxemia, is
one of the dangers to a fetus when its mother has uncontrolled
asthma.
Researchers, whose findings appeared in the Journal of
Allergy and Clinical Immunology, used information on more than
25,000 pregnancies from a prescription database in the
Netherlands.
More than 2,000 of those pregnant women, about 8 percent,
received a prescription for an asthma medication at least once
during the study period, from 1994 to 2009.
Both the Global Initiative for Asthma (GINA) and the U.S.
National Asthma Education and Prevention Program recommend that
women continue taking asthma medications throughout pregnancy,
because the risks of exacerbated asthma are greater than the
risks of the medications.
Between 1994 and 2003, the women’s rate of asthma control
medication prescriptions held steady before, during and after
pregnancy, said the researchers, led by Priscilla Zetstra-van
der Woude at the University of Groningen.
From 2004 to 2009, however, the researchers saw a drop of 30
percent in the rate of asthma prescriptions filled in the first
three months of pregnancy, compared to the months before
becoming pregnant.
“Many women stop or reduce their use of asthma medications
when they become pregnant. Strategies to safely control asthma
during pregnancy are needed,” the researchers wrote.
When Zetstra-van der Woude’s group looked at the types of
medications that women were cutting out, they saw that
long-acting bronchodilators and combinations of these drugs with
inhaled corticosteroids – used to keep moderate to severe asthma
under control – were less popular during pregnancy than shortly
before.
Prescriptions for these drugs declined by about 50 percent
during the first trimester, from roughly 1.2 percent of
pregnancies in the database down to 0.6 percent.
“Long-acting bronchodilators are usually prescribed for
patients with more severe asthma, and discontinuation could lead
to severe symptoms of respiratory distress,” they wrote.
The study could not say whether the drop off in asthma
medications had any negative effects on the mother or baby, and
it’s possible that women did not have any worsening of symptoms.
The researchers could also not determine why moms-to-be stop
taking their meds, or whether it led to any negative health
effects, but the findings are concerning, said Lucie Blais, a
pharmacy professor at the University of Montreal, who was not
involved in the study.
“Some studies show that uncontrolled asthma is bad for the
fetus,” she said. “You can have babies that will be small for
their gestational age or birth weight.”
But researchers also noted that the course of asthma often
changes during pregnancy, with some women having relief from
symptoms and thus needing less or no medication – which is not a
problem as long as the asthma is controlled.
SOURCE: http://tinyurl.com/9uuelcy
(Reporting from New York by Kerry Grens at Reuters Health;
editing by Elaine Lies)
