General Obstetrics and Gynecology: ObstetricsCessation of asthma medication in early pregnancy
Section snippets
Material and methods
We conducted a cohort study of 8149 pregnant women with asthma drawn from a population of 112,171 white and black pregnant women aged 15 to 44 years, with singleton gestations, enrolled in the Tennessee Medicaid program during 1995 to 2001, and with at least 180 days of continuous enrollment prior to their last menstrual period (LMP). These requirements captured 48% of deliveries to mothers enrolled in Medicaid and approximately 21% of all births to Tennessee residents from 1995 to 2001.
Results
The study cohort consisted of 8149 pregnant women with asthma. Mean maternal age was 24 ± 5 years, 67.9% were white, 39.1% were married, and 38.2% smoked. Overall, 83% of women used any asthma medication, 30% used inhaled anti-inflammatory agents, 77% used inhaled beta-agonists, and 28% used rescue corticosteroids during the study period. On average, in any single week prior to pregnancy 19% of women were users of any asthma medication, 5% used inhaled anti-inflammatory agents, 18% used inhaled
Comment
The results of this study suggest that women on Medicaid decrease and/or stop asthma medications during early pregnancy despite national guidelines recommending continued use.5 We observed a 23% drop in use of inhaled corticosteroids, a 13% drop in beta-agonist use, and a 54% drop in rescue corticosteroid use. These results are similar to results of a survey among women receiving asthma case management from a managed care organization, which found that 39% of women discontinued or reduced
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Maternal asthma in relation to infant size and body composition
2023, Journal of Allergy and Clinical Immunology: GlobalStatus Asthmaticus Gravidus: Emergency and Critical Care Management of Acute Severe Asthma During Pregnancy
2023, Immunology and Allergy Clinics of North AmericaCitation Excerpt :This undertreatment is thought to be due to the lack of understanding about asthma and to the concern that medical treatment can affect the health of the fetus.6 One study found that despite dedicated educational interventions, pregnant asthma patients demonstrated reductions in the use of key asthma medications including inhaled corticosteroids (23%), short-acting beta-agonists (13%), and oral corticosteroids (54%).14 In addition, asthma is more common in women and can result in more frequent hospitalizations and serious complications, especially during the gestational ages of women from 20 to 50 years.6
Determining the Clinical Course of Asthma in Pregnancy
2022, Journal of Allergy and Clinical Immunology: In PracticeThe safety of asthma medications during pregnancy and lactation: Clinical management and research priorities
2021, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Moreover, treatments used may be missed if prescriptions were filled before the exposure window (eg, an old prescription still being used). The observed irregular prescription dispensing patterns in database studies support the difficulties of assessing asthma treatment use based on pharmacy claims.61,64 Population-based case-control studies can make a unique contribution to understanding the safety or risk of asthma medication use in pregnancy by providing an efficient study design to detect increases in specific serious birth defects.
Factors Associated with Nonadherence to Inhaled Corticosteroids for Asthma During Pregnancy
2021, Journal of Allergy and Clinical Immunology: In PracticeAsthma in Pregnancy
2021, Encyclopedia of Respiratory Medicine, Second Edition
Supported in part by research grants UO1 HL 72471, MO1 RR00095, and KO8 AI01582, Agency for Healthcare Research and Quality, Centers for Education and Research Grant U18-HS10384, Geriatric Research Education and Clinical Center, Department of Veterans Affairs, and the Food and Drug Administration FD-U-000073.