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"While a person should obviously use the minimum amount of medication necessary in any circumstances, a pregnant woman can get herself into much more trouble if she doesn't control her asthma," says Dr. Brian Sproule, clinical director of the Alberta Asthma Centre in Edmonton. According to a fact sheet on asthma and pregnancy on The Lung Association website (http://www.lung.calasthmalpregnancy/pregnant.html): "The risks of uncontrolled asthma are far greater than the risks to the mother or fetus from the medication used to control asthma.... breathing difficulties in the mother affect the fetus by compromising the oxygen supply." Problems associated with uncontrolled asthma include premature birth, low birth weight and blood pressure changes in the mother. Dr. John Hickey, a general practitioner on the staff of St. Martha's Regional Hospital in Antigonish, Nova Scotia, adds increased incidence of abortion and even death to the list. Writing in The Berries, an Internet newsletter from St. Martha's for family practitioners, he stresses the importance of continuing use of prescribed asthma medications throughout pregnancy along with avoidance of known triggers and close monitoring by the woman's physician. "Inhaled bronchodilators are safe to use in pregnancy in the usual doses," he says. "In fact, the patient should follow her usual treatment regime with respect to the management of her asthma." An increasing number of studies have shown that most asthma medications are safe during pregnancy. "Fortunately all the conventional asthma drugs can be used quite safely," confirms Dr. Sproule. He adds that some caution is recommended with respect to newer drugs on the market. "While they are probably safe, not enough is known about new medications." Dr. Karen Rimmer, a Calgary respiratory physician, agrees. "Some drugs have a longer track record, so we tend to steer away from the newer ones. They're probably safe, but we tend to be cautious." The important thing is "to treat the patient similarly as she was treated before the pregnancy," Dr. Rimmer says. "If she was on a newer drug, we may switch her to an older one in the same class of drugs."
Asthmatic women and their fetuses need to be monitored closely during labor and delivery, and their asthma medications should be continued during that time. Mothers should not hesitate to ask for a painkiller, according to The Lung Association website. In fact, the painkiller may help limit the risk of bronchospasm. For some women the problem will never come up. Among asthmatics that get pregnant, one third will experience a worsening of their asthma, one third remain the same, and one third actually improve. This lucky last group may even be able to reduce their medication during pregnancy. However, they may need to increase their medication immediately following delivery. Asthma drugs are also a concern for nursing mothers. However, both Dr. Rimmer and Dr. Sproule say new mothers who breastfeed need not worry about using their asthma medication. "Oral steroids can come through in small quantities, but generally we don't alter medication during breastfeeding," Dr. Rimmer says. Browse other articles on this site. |
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