2009年4月29日 星期三

Asthma in Pregnancy

Asthma Testing in Pregnancy
The demonstration of a reduced FEV1 or ratio of FEV1 to forced vital capacity (FVC) with a 12% or greater improvement in FEV1 after the administration of inhaled albuterol confirms a diagnosis of asthma in pregnancy. Methacholine testing which is used to confirm bronchial hyperactivity in patients with normal pulmonary function, is contraindicated during pregnancy because of the lack of data on the safety of such testing in pregnant patients.

Inhaled β-agonists and Inhaled SteroidsMany studies have shown no increased perinatal risks (including preeclampsia, preterm birth, low birth weight, and congenital malformations) associated with the use of inhaled β-agonists or inhaled corticosteroids in women who were exposed to these agents. Among the drugs for which reassuring data on use in pregnancy are available, albuterol is the inhaled β-agonist that has been studied most extensively, and budesonide is the most extensively studied inhaled corticosteroid.

Q: What are the risks of using oral corticosteroids for the treatment of asthma during pregnancy?
A: The use of oral corticosteroids among pregnant women with asthma has been associated with increased risks of preeclampsia and prematurity among their offspring, as compared with the use of other asthma medications.

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NEJM 2009 April

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