Women often stop asthma therapy in early pregnancy

NEW YORK, July 20 (Reuters) Many women significantly reduce their use of asthma medications in early pregnancy, placing them and their infants at risk, according to a report in the July issue of American Journal of Obstetrics and Gynecology.

However, national treatment guidelines recommend continued use of these potentially life-saving drugs.

''Many women will assume that continued use of asthma medications during pregnancy is bad and will discontinue their medications on their own,'' Dr Tina V Hartert from Vanderbilt University School of Medicine, Nashville, Tennessee told Reuters Health.

Hartert and colleagues used data from more than 8,000 pregnant women with asthma who were enrolled in the Tennessee Medicaid program to investigate whether women alter their use of asthma medications during pregnancy.

By 13 weeks of pregnancy, the use of inhaled anti-inflammatory drugs had fallen by 22.9 per cent; the use of short-acting beta-agonist, such as albuterol, for quick relief of symptoms, had fallen by 13.2 per cent; and the use of rescue corticosteroids (steroids) had decreased by 54.3 per cent, the authors report.

The use of all classes of asthma medication increased from weeks 6 to 13 and from weeks 13 to 26 of pregnancy, the researchers note, but only the use of short-acting beta-agonists showed a statistically significant rebound by week 26.

''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,'' the investigators conclude.

''Both primary care physicians, as well as providers that care for women during pregnancy, should educate women early and frequently about the importance of continuing to control their asthma and ensure that they are using appropriate medication,'' Hartert said.

''Pregnant women already know that they are 'eating for two'; a useful message is that they are also 'breathing for two.''' ''The Bureau of TennCare (Tennessee Medicaid) now requires managed care organizations to provide disease management to both high-risk pregnant women and high-risk asthmatics,'' Hartert explained. ''While asthma during pregnancy has not been specifically addressed, we hope that publication of this peer-reviewed study will communicate the risks identified in this paper to managed care organizations.'' REUTERS SP HS1015