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Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic womenLucie Blais, PhD, Amélie Forget, MSc If ever there was a time to keep asthma well controlled, it is during pregnancy when a woman is breathing for two and, even more so, during the first trimester when the fetus is undergoing crucial development of limbs and vital organs. Pregnant patients sometimes seem to be conflicted over which is worse for the baby: their asthma or the medications used to control it. The results of this study published in the May edition of JACI, show an increased risk of major congenital malformations (birth defects) among babies born to women who had an asthma attack during the first trimester of their pregnancy. A congenital malformation was classified as major if it could be life-threatening or cause major cosmetic defects. Although previous studies have shown oral corticosteroids such as prednisone to be associated with an increased risk of congenital malformations like cleft lip, cleft palate, or both, this study shows that women who had an asthma attack requiring an Emergency Department visit or a hospitalization for asthma during the first trimester of pregnancy but who did not fill a prescription for oral corticosteroids were twice as likely to have a baby with a major congenital malformation as women who did not experience an attack. This tells us that severe uncontrolled asthma might put the baby more at risk for birth defects than treatment with prednisone. The advice from the authors is that health professionals should encourage their pregnant asthmatic patients to continue their controller therapy. This will enable them to manage their asthma symptoms, avoid exacerbations and, very importantly, reduce the risk of congenital malformations in their babies. |
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