Sammanfattning
Background: Adequate symptom control is essential for pregnant women, as poorly controlled asthma may negatively affect the pregnancy outcome. The aim of this review is to summarize current knowledge about the use of asthma medications during pregnancy, with special focus on safety of use during pregnancy.
Material and methods: The review is based on a qualified selection of relevant literature identified by search in PubMed and Embase. Additional papers were found by screening the reference lists of the identified papers. In addition, Norwegian and international treatment guidelines were reviewed.
Results: Overall, the literature is clear that there is no need to advice against necessary use of asthma medication among pregnant women. Asthma management is mainly constituted by medications for inhalation. As low medication levels reach systemic circulation after such local administration, effects on the fetus are not likely. Even though some studies have found an increased risk of malformations, other studies provide reassuring results. It cannot be ruled out that the negative effect findings are explained by the maternal asthma itself. Altogether, the safety data on asthma medications are reassuring, and there is a general consensus that the benefits of a well-controlled asthma clearly outweigh the possible risks of asthma medications.
Conclusion: The general consensus in the literature is that pharmacological treatment of pregnant women with asthma should be the same as for non-pregnant patients, and that the benefits of using asthma medications to obtain a well-controlled asthma outweigh the potential risks. There seems to be an agreement that uncontrolled asthma increases perinatal risk, whereas well-controlled asthma reduces the risk.