Pregnant women with asthma can be more confident about some medicines

Dec 3 2008

Women can usually keep using the same asthma drugs they were using before they got pregnant.

Budesonide sprays are the best studied and can be regarded as safe. More trials of other essential medicines are necessary however. According to the German Institute for Quality and Efficiency in Health Care (IQWiG), more data from trials could reassure women who worry about the safety of their drugs during pregnancy. The Institute has reviewed the evidence on asthma in pregnancy and published information for pregnant women on its website, www.informedhealthonline.org.

Pregnant women with asthma want to know whether it is possible for the medications they take to harm their baby - and they want to know what they can do to reduce the risks of their asthma for their unborn baby. "Regulations ensure that drug product information lists unanswered safety questions about use in pregnancy. That can be somewhat misleading and cause anxiety. Imprecise research results in medical journals sometimes lead to worrying media reports. Some recent reports in Germany even wrongly suggested that asthma drugs could cause a malformation rate of almost 10%," according to the Institute's Director, Professor Peter Sawicki.

Essential medicines are generally not researched enough in pregnancy, and so remain associated with a lot of uncertainty. This can be a big problem for pregnant women. Professor Sawicki said: "In some countries large birth registers provide information on medication use in pregnancy and malformations in babies. But that cannot replace the more precise assessment from trials. There need to more trials that pregnant women can participate in. We need more reliable knowledge about the effects of essential medicines in pregnancy."

Good self-management can keep asthma under control. "For women with asthma who have not been actively self-managing their asthma, pregnancy is a good time to start," Professor Sawicki said. "Good asthma control prevents asthma attacks, and that ensures that the baby's oxygen supply is not interrupted. It lowers the risk of needing to be hospitalised with an asthma attack."

Women with asthma can usually keep using the same medications during pregnancy that helped them before. Pregnancy is not a good time to try out treatments where little is known about the effects on unborn babies. Most asthma medications have not been studied in trials that include pregnant women. However, budesonide sprays have been studied enough: women can be confident about budesonide's safety for pregnancy. Budesonide is a steroid.

Quitting smoking is the best thing a woman can do to protect her baby from developing asthma. "Researchers are studying a variety of options for preventing asthma in babies, including diet and probiotics. Quitting smoking is the only effective prevention that has been demonstrated to date", according to Professor Sawicki. This also counts for the father: when parents quit smoking, they can reduce the risk that their child will later develop asthma or allergies.