The safety of asthma and allergy medications during pregnancy☆,☆☆,★,★★
Section snippets
Subjects and medications
Subjects were participants in the Kaiser-Permanente Prospective Study of Asthma During Pregnancy, the methodology of which has been previously described.11 Briefly, subjects registering for prenatal care at San Diego Kaiser-Permanente Health Care Plan between June 1978 and December 1989 were asked to complete a questionnaire regarding their history of asthma or symptoms of asthma. All subjects with asthma were recruited to enter the study, and control subjects without asthma who matched a
Results
The incidence of spontaneous abortion was higher in subjects with asthma than in control subjects (Table I). However, the significance of this observation is uncertain because subjects with asthma generally entered the study earlier in their pregnancies, according to the study protocol. The incidence of oral corticosteroid use in subjects with asthma experiencing spontaneous abortions (10.5%) was less than that in subjects with asthma not experiencing a spontaneous abortion (15.7%).
No
Discussion
No prior studies of asthma or allergy medications or asthma during pregnancy have reported an increased incidence of congenital malformations.4, 5, 6, 7, 8, 9, 10, 11, 14, 15, 16, 17, 18, 19 This study adds additional reassuring data regarding antihistamines (especially chlorpheniramine and tripelennamine), decongestants (especially pseudoephedrine), inhaled β-agonists (especially terbutaline and metaproterenol), theophylline, inhaled or intranasal cromolyn, inhaled or intranasal
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Cited by (237)
Chronic Management of Asthma During Pregnancy
2023, Immunology and Allergy Clinics of North AmericaUse of Asthma Medication During Gestation and Risk of Specific Congenital Anomalies
2023, Immunology and Allergy Clinics of North AmericaCitation Excerpt :Concerns raised about a potential association of congenital anomalies and moderate- to high-dose ICSs have been examined. A previous literature review32 summarizing the risk of congenital malformations with the use of ICSs in pregnancy found that in 15 separate studies29,33–46 comparing women with asthma using any ICS versus women with asthma not using ICS the adjusted relative risk ranged from 0.4 to 1.1. Bakhireva and colleagues35 were the only investigators to report a significantly increased risk of congenital anomalies associated with ICS use when they compared 438 pregnant women using ICSs during pregnancy with nonasthmatic control pregnant women (4.1% vs 0.3% presence of major anomalies, respectively, P = <0.05).
Medical management of rhinitis in pregnancy
2022, Auris Nasus LarynxExposure to Allergen-Specific Immunotherapy in Pregnancy and Risk of Congenital Malformations and Other Adverse Pregnancy Outcomes
2022, Journal of Allergy and Clinical Immunology: In PracticeManagement of asthma during pregnancy
2021, Revue des Maladies Respiratoires
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From the Departments of Allergy, Obstetrics and Gynecology, and Research and Evaluation, Kaiser-Permanente Medical Center, San Diego.
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Supported in part by Grant No. AI 20426 fron the Asthma and Allergy Branch of the National Institiute of Allergy and Infectious Diseases and a grant fron the Kaiser Foundation Hospital Research Foundation.
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Reprint requests: Michael Schatz, MD, Department of Allergy, Kaiser-Permanente Medical Center, 7060 Clairemont Mesa Blvd., San Diego, CA 92111.
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