Bronchial asthma and pregnancy
DOI:
https://doi.org/10.18597/rcog.453Keywords:
asthma, pregnancy, bronchospasm, respiratory failureAbstract
Asthma is present in 4-7% of pregnant women. The course of asthma during pregnancy varies, a third remaining stable, another third improving and the rest getting worse. Asthmatic women have an increased risk of gestational arterial hypertension, preeclampsia, gravidarum hyperemesis, placenta previa, vaginal haemorrhage and induced and/or complicated childbirth.
Objective: this work was aimed at reviewing the epidemiology, clinical classification, diagnosis and treatment of asthma during pregnancy.
Materials and methods: using the key words described in the second sentence in the Introduction to search for information in PUBMED/Medline, Cochrane, SciELO databases, as well as in articles in journals and texts, mainly covering the last 5 years. Search results gave 84 references of which the 39 most relevant were taken.
Results: good control of asthma during pregnancy avoids or reduces maternal and foetal complications.
Conclusion: better control of pulmonary function during pregnancy is independently associated with increased foetal growth.
Author Biographies
Eduardo Contreras-Zúñiga
Fernando Sanabria
Sandra Ximena Zuluaga-Martínez
Isabel Cristina Casas-Quiroga
References
Adams BK, Cydulka RK. Asthma evaluation and management. Emerg Med Clin North Am 2003;21:315-30.
Alhoun W. Mild asthma: is it time for a new classification? En: American Asthma Association Initiative Annual Meeting; Denver, USA; 2003.
Hansen WF, Yankowitz J. Pharmacologic therapy for medical disorders during pregnancy. Clin Obstet Gynecol 2002;45:136-52.
Jadad AR, Moher M, Browman GP, Booker l, Sigous C, Fuentes M, et al. Systematic reviews and metaanalysis on treatment of asthma: critical evaluation. BMJ 2000;320:537-40.
Environmental allergen avoidance in allergic asthma. Ad Hoc Group of Environmental Allergens and Asthma from the American Academy of Allergy, Asthma and Inmunology. 2004. Visitado 2006 Jun 28. Disponible en: http://www.aaaai.org/media/resources/academy_statements/position_statements/ps36.asp
Finotto S, Neurath MF, Glickman JN, Qin S, Lehr HA, Green FH, et al. Development of spontaneous airway changes consistent with human asthma in mice lacking T-bet. Science 2002;295:336-8.
Murdock MP. Asthma in pregnancy. J Perinat Neonatal Nurs 2002;15:27-36.
Paris-Kohler A, Megret-Gabeaud ML, Fabre C, Mares P, Vincent D. The allergic pregnant woman. Allerg Immunol (Paris) 2004;33:399-403.
Dombrowski MP. Asthma and pregnancy. Obstet Gynecol 2006;108:667-81.
Dombrowski MP, Schatz M, Wise R, Momirova V, Landon M, Mabie W, et al. Asthma during pregnancy. Obstet Gynecol 2004;103:5-12.
National Asthma Education Program. Report of the working group on asthma and pregnancy: management of asthma during pregnancy. Bethesda, MD: National Heart, Lung, and Blood Institute. National Institutes of Health. NIH Pub No. 93-3279A; 1993.
National Institutes of Health (NIH), National Heart, Lung, and Blood Institute (NHLBI), National Asthma Education and Prevention Program. Expert Panel Report 2. Guidelines for the Diagnosis and Management of Asthma. Clinical Practice Guidelines. NIH Pub No. 97-4051. Bethesda, MD: NIH, July 1997. Visitado 2006 Jun 28. Disponible en: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
Rodrigo GJ, Rodrigo C, Hall JB. Acute asthma in adults: a review. Chest 2004;125:1081-102.
Boulet LP, Becker A, Berube D, Beveridge R, Ernst P. Canadian asthma consensus report, 1999. Canadian Asthma Consensus Group. CMAJ 1999;161(11 Suppl):S1-61.
Bracken MB, Triche EW, Belanger K, Saftlas A, Beckett WS, Leaderer BP. Asthma symptoms, severity, and drug therapy: a prospective study of effects on 2205 pregnancies. Obstet Gynecol 2003;102:739-52.
British guideline on the Management of Asthma. Thorax. British Thoracic Society. Scottish Intercollegiate Guidelines Network. Thorax 2003;58 (Suppl 1):1-94.
Powrie RO. Drugs in pregnancy. Respiratory disease. Best Pract Res Clin Obstet Gynaecol 2001;15:913-36.
Lao TT, Huengsburg M. Labour and delivery in mothers with asthma. Eur J Obstet Gynecol Reprod Biol 1990;35:183-90.
Schatz M, Dombrowski MP, Wise R, Momirova V, Landon M, Mabie W, et al. Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol 2006;194:120-6.
Barnes PJ, Chung KF, Page CP. Inflammatory mediators of asthma: an update. Pharmacol Rev 1998;50:515-96.
Bousquet J, Jeffery PK, Busse WW, Johnson M, Vignola AM. Asthma: from bronchoconstriction to airways inflammation and remodelling. Am J Respir Crit Care Med 2000;161:1720-45.
National Institutes of Health, National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Working group report on managing asthma during pregnancy: recommendations for pharmacologic treatment, update 2004. Visitado 2006 Jun 28. Disponible en: http://www.nhlbi.nih.gov/health/prof/lung/asthma/astpreg/astpreg_full.pdf
Barnes PJ. Scientific rationale for inhaled combination therapy with long-acting beta2-agonists and corticosteroids. Eur Respir J 2002;19:182-91.
Cockcroft DW, Murdock KY. Comparative effects of inhaled salbutamol, sodium cromoglycate, and beclomethasone dipropionate on allergen-induced early asthmatic responses, late asthmatic responses, and increased bronchial responsiveness to histamine. J Allergy Clin Immunol 1987;79:734-40.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. National Institutes of Health. National Heart, Lung, and Blood Institute. NIH Pub No. 02-3659. Revised 2002.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention NHLBI/WHO Workshop Report. 2002. Visitado en 2006 Jun 28. Disponible en: http://www.ginasthma.com
Juergens UR, Degenhardt V, Stober M, Vetter H. New insights in the bronchodilator y and antiinflammatory mechanisms of action of theophylline. Arzneimittelforschung 1999;49:694-8.
Plotnick LH, Ducharme FM. Combined inhaled anticholinergics and Beta 2 agonists for initial treatment of acute asthma (Cochrane review). En: The Cochrane Library, Issue 3, 2002. Oxford, UK: Update Software.
Guía Española para el Manejo del Asma (GEMA). Ediciones Mayo S.A. 2003.
Sears MR. Natural history and epidemiology. En: Fitzgerald JM, Ernst P, Boulet LPh, O’Byrne PM, eds. Evidence-based asthma management. Hamilton (Ont): BC Decker Inc.; 2001.
Ernst P, Spitzer WO, Suissa S, Cockcroft D, Habbick B, Horwitz RI, et al. Risk of fatal and near-fatal asthma in relation to inhaled corticosteroid use. JAMA 1992;268:3462-4
Haahtela T, Jarvinen M, Kava T, Kiviranta K, Koskinen S, Lehtonen K, et al. Comparison of beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma. N Engl J Med 1991;325:338-92.
Sorensen TK, Dempsey JC, Xiao R, Frederick IO, Luthy DA, Williams MA. Maternal asthma and risk of preterm delivery. Ann Epidemiol 2003;13:267-72.
Kallen B, Rydhstroem H, Aberg A. Congenital malformations after the use of inhaled budesonide in early pregnancy. Obstet Gynecol 1999;93:392-5.
Lemanske RF Jr, Sorkness CA, Mauger EA, Lazarus SC, Boushey HA, Fahy JV, et al. Inhaled corticosteroid reduction and elimination in patients with persistent asthma receiving salmeterol: a randomized controlled trial. JAMA. 2001;285:2594-603.
Rowe BH, Spooner CH, Ducharme FM, Bretzlaff JA, Bota GW. Corticosteroids for preventing relapse following acute exacerbations of asthma. Cochrane Database Syst Rev 2001;(1):CD000195.
Janson C, Anto J, Burney P, Chinn S, de Marco R, Heinrich J, et al. The European Community Respiratory Health Survey: what are the main results so far? European Community Respiratory Health Survey II. Eur Respir J 2001;18:598-611.
Dombrowski MP, Schatz M, Wise R, Thom EA, Landon M, Mabie W, et al. Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy. Am J Obstet Gynecol 2004;190:737-44.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
