Managing Asthma During Pregnancy
- Sunday, September 13, 2009, 5:34
- Asthma
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- Maureen:
- The question is, I’m considering, or hoping to at least, get pregnant within the next couple of months. And I’m concerned about the effects of my current medications on the developing fetus. My current medications include a steroid inhaler, which is a Beclovent. The other inhalers that I’m on are a Serevent inhaler and an Albuterol inhaler, which I think also goes by the name of Anseril?
- Dr. Ayars:
- Actually it’s Proventil or Ventilin are the tradenames for that.
- Andrew:
- And you’re concerned whether these drugs are not good for you during pregnancy.
- Maureen:
- Right. My primary physician indicated that the cortisone, the steroid inhaler, the Beclovent is potentially a problem. And that the other two basically aren’t. I have concerns about taking anything of course, during pregnancy. But I’m particularly concerned now about the Beclovent and I’m trying to figure out what I should do, how I should manage this?
- Dr. Ayars:
- Actually, there is a surprisingly easy answer to this question. Basically, we manage asthma exactly the same whether you’re pregnant or not. In fact, if anything, we manage it more aggressively, because the most important thing is to make sure you get good oxygenation to the fetus. There’s just about no evidence of any harm with any of the drugs that we use for asthma in pregnancy. So, we feel very comfortable using all of them that are necessary. We cannot let the pregnant mother die of asthma. That doesn’t do her any good. So even if they need prednisone during pregnancy, we give it to them, because the mom has to breathe to get oxygen to the fetus. So, you can feel very comfortable that most of us who manage asthma as a specialty feel comfortable using inhaled steroids during pregnancy.
- Maureen:
- Really?
- Dr. Ayars:
- Yes, and it’s a standard thing to use. Because you need to breathe.
- Maureen:
- Have there been studies of the effects, or is it just sort of anecdotal at this point, or?
- Dr. Ayars:
- The easy answer to that is no studies are done during pregnancy, because no drug company wants to touch that risk with a 10-foot pole. The truth of the matter is, there are very few drugs that have been shown to be harmful during pregnancy but there are a few very dramatic examples where it is bad. If a drug company did a study and something came out wrong with a fetus, they’d get blamed even if the drug had nothing to do with it. So they don’t want to touch that. On the other hand, because the diseases like asthma and other things are so common, obviously we have to treat these patients and so by experience we’ve been using all these drugs during pregnancy for many, many years and we have no evidence of any harm during pregnancy. I’m sure that some of that information isn’t disseminated out to the OB/GYN docs or some of the family practice docs, but we feel very comfortable treating asthma exactly the same during pregnancy as if you’re not pregnant.
- Maureen:
- I’m on fairly high doses. Do you feel that there’s some benefit in at least cutting down? The main reason, my asthma gets particularly bad if I’m engaged in strenuous exercise or if I’m exposed to certain allergens. My plan was to kind of cut back a little bit on the intensity of my workouts because I probably don’t need quite as much, honestly, if I’m not working out so much. And then to just be real careful about avoiding things that are known allergens to me.
- Dr. Ayars:
- That would be fine if you wanted to do that. But my feeling about it is why don’t you be just as active and enjoy your life and your pregnancy and use what has worked for you, because we really don’t have any evidence that it is harmful during pregnancy at this time. And we do want you to be active, and like I said, you do need to breathe normally during pregnancy.
- Maureen:
- Okay. Well that’s great. That’s very comforting to know. I really wasn’t expecting that answer. I thought I’d have to do something else.
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