Effect of Maternal Asthma and Gestational Asthma Therapy on Fetal Growth

Abstract

Asthma is a common chronic condition that might seriously complicate pregnancy and fetal development. This article provides a comprehensive review of the existing literature regarding the effect on fetal growth of maternal asthma and common asthma medications used during pregnancy, including short-and long-acting beta (2)-agonists, inhaled and oral corticosteroids, chromones, leukotriene receptor agonists, and theophylline. Evaluated outcomes of fetal growth include low birth weight, mean birth weight, small for gestational age, birth length and head circumference, and measures of asymmetrical growth retardation. Methodological and practical considerations related to safety of asthma medications in pregnancy and management of gestational asthma are discussed.

Safety of leukotriene receptor antagonists in pregnancy

“…6 Slightly decreased birth weight in infants born to women who used LTRAs in our study is most likely attributable to more severe and/or poorly controlled maternal asthma in that group. Maternal asthma has been associated with an increased risk of low birth weight, [26][27][28][29] reduced mean birth weight, 28,30 and intrauterine growth restriction 6,26,31,32 (reviewed by Bakhireva et al 22 ). Moreover, relationships have been reported between reduced intrauterine growth and more severe or poorly controlled asthma, as defined by lower pulmonary function, 5 increased symptoms, 6 or exacerbations.…”

“…Gestational age-specific and sex-specific percentiles for birth weight, height, and head circumference were defined as small for gestational age if they were 10th percentile. 22 Ponderal index was evaluated as a measure of asymmetrical intrauterine growth restriction, 23 calculated as birth weight (g)/birth length (cm) 3 , and dichotomized as normal (2.2) or low (<2.2). Preterm delivery was defined as < 37 completed weeks gestation.…”

Self-regulation and women with asthma

“…There was a modest risk for miscarriage. Baibergenova et al [26] also reported no adverse effects in pregnancy among the 530 women with asthma who were studied, while Bakhireva et al [27 ] found no or minimal effect of asthma medicines on fetal growth for pregnant women with asthma and that perinatal complications were reduced among women with well managed disease.…”

Medication Exposure in Pregnancy Risk Evaluation Program: The Prevalence of Asthma Medication Use During Pregnancy

“…Previous studies found increased risks for birth defects and other adverse pregnancy outcomes including oral clefts, spontaneous abortion or stillbirth, preterm delivery, preeclampsia, low birth weight, neonatal hypoxia, and cesarean section (4-6). Previous studies are based on pregnancy registries, birth defects surveillance programs, observational cohort studies, and case-control studies.…”