A population analysis of prescriptions for asthma medications during pregnancy.

BACKGROUND: It is important to control asthma during pregnancy. However, some studies indicate that women stop or change their asthma medications when they become pregnant. OBJECTIVE: We used a population database to analyze changes in prescriptions for asthma medications to patients before, during, and after pregnancy. METHODS: We collected information from a pregnancy database that is part of the population-based pharmacy prescription InterAction Database from the northern Netherlands. Our study cohort comprised 25,709 pregnancies for which prescription data were available. We collected data over a study period of 1 year before pregnancy until 6 months after birth and analyzed data from pregnant women who received at least 1 prescription for asthma medication during the study period (n = 2072), identifying all prescriptions for asthma medication and oral corticosteroids. RESULTS: Prescriptions for asthma medications did not change during pregnancies from 1994-2003. However, during the 2004-2009 period, there was a significant decrease (P = .017) in prescriptions for asthma medications during the first months of pregnancy compared with the months before pregnancy, especially prescriptions of long-acting bronchodilators. Although most asthma prescriptions continued throughout pregnancy, prescriptions for controller therapies were reduced by 30% during the first months of pregnancy. CONCLUSIONS: Many women stop or reduce their use of asthma medications when they become pregnant. Strategies to safely control asthma during pregnancy are needed.

[Treatment of asthma during pregnancy]. / Behandeling van astma tijdens de zwangerschap.

Treatment of asthma during pregnancy leads to discussion concerning medication and complications of pregnancy.Insecurity about possible teratogenity leads in the first trimester in 40% of pregnant women to reduction or cessation of asthma medication.This results, in pregnant women with moderate to severe asthma, in an increased consumption of rescue medication and number of exacerbations, and reduced asthma control. Asthma-exacerbations are significantly correlated with low birthweight. Of the majority of asthma medications, consumption during pregnancy has not been shown to cause harmful effects on the foetus. Adequate therapy for maintenance and exacerbations are essential, noting that the treatment in essence should not differ between pregnant and nonpregnant asthmatic women. A preconceptional consultation by a pulmonary physician and gynaecologist could improve care for pregnant women with asthma.