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Asthma Management During Pregnancy

INADEQUATE ASTHMA MANAGEMENT DURING PREGNANCY LINKED TO SIGNIFICANT MORBIDITY

Highlights from the American Thoracic Society Meeting, San Francisco, May 21, 1997 (Reuters)

"Suboptimal asthma management contributes to asthma exacerbations during pregnancy and may lead to significant morbidity..." in pregnant women, Dr. Ather Siddiqi said today in a poster presentation here. Dr. Siddiqi and colleagues investigated risk factors and outcomes in 25 pregnant asthmatics admitted to a hospital for exacerbations. Thirteen of the women had been previously admitted for acute asthma, and 2 of the 13 had required ventilatory support on prior admission. Although 18 had been using beta agonists regularly, only 7 used inhaled corticosteroids. Further, only 18 had regular antepartum outpatient follow-up, Dr. Siddiqi said. During the study period, four patients required admission to the ICU and two required ventilatory support. Five patients had to be admitted twice to the hospital during the same pregnancy with a diagnosis of acute exacerbation of asthma. Although there were no maternal or fetal deaths, birth weights tended to be low in this cohort, Dr. Siddiqi told Reuters Health in an interview. Seven deliveries were by cesarean section and 4 were preterm. Further investigation revealed that "...asthma was being treated by an obstetrician in many cases, rather than a primary care physician or an asthma specialist. We're not sure if any of the women received pulmonary measurements during pregnancy," he said. "The main message is that inhaled glucocorticoids seem pretty safe in asthma and in pregnancy," Dr. Siddiqi told Reuters Health, "...and that pregnant women should at least think about taking them throughout. If they or their physicians don't feel comfortable with this prescription, then they should get input from a specialist."

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