Treatment for Asthma Urged During Pregnancy

Asthma should be treated just as aggressively in pregnant women as it is in the general population, federal health officials urged Monday in a new report that they predicted would have a major impact.

The report concluded that the dangers of uncontrolled asthma are far greater to the mother and fetus than any known risks associated with asthma medications.

In the past, physicians often shied away from prescribing asthma medications to pregnant women because of growing medical concerns that any drugs posed a threat to a developing fetus.

“A pregnant mother is breathing for two,” said Dr. Allan T. Luskin, chairman of the asthma and pregnancy working group for the National Heart, Lung and Blood Institute’s asthma education program. “It’s imperative that she be able to deliver oxygen--regularly and unimpeded--to her baby. Better care of pregnant women with asthma will result in healthier babies and fewer infant deaths.”

Asthma, which can be life-threatening, is characterized by a temporary blockage of the bronchial airways, the tubes through which people breathe. Typical symptoms include coughing, wheezing, shortness of breath and chest tightness.

An asthma attack can be triggered by any number of things, including exercise; irritants, such as tobacco smoke; cold temperatures, and allergens, including pollen, dust, animal dander and certain foods.

Between 1979 and 1989, the prevalence of asthma in the United States increased a startling 60%, the government said. No one knows exactly why, although some have attributed the rise in cases to such factors as better diagnosis of asthma and an increase of pollutants and other allergens in the environment.

About 12 million Americans suffer from asthma, and the government estimates that the disease complicates 4% of pregnancies in this country.

The report was developed by 12 physicians with expertise in pediatrics and allergy, pulmonary and obstetrical care.

“Up to now, people have been much more concerned about the adverse effects of medication rather than the adverse effects of the asthma,” said Dr. Michael Schatz, an allergist who is associate clinical professor at the UC San Diego School of Medicine, and who served on the panel that issued the report.

“The overall perception with asthma is that it may not be a serious disease,” he added. “But for some, it is absolutely life-threatening, and for many it is life-altering. Now we realize that it also has its effects during pregnancy as well.”

Schatz said accurate diagnosis and treatment of asthma in a pregnant woman is critical, even if her symptoms are mild.