MONDAY, Dec. 14, 2020 — Prescription of asthma medications before and during pregnancy is associated with increased prevalence of adverse perinatal outcomes, especially with discontinuation of prescriptions, according to a study published online Dec. 9 in PLOS ONE.

Gareth Davies, from Swansea University in the United Kingdom, and colleagues examined the associations of exposures to medicines prescribed for asthma and their discontinuation in pregnancy with adverse perinatal outcomes such as preterm birth, small for gestational age (SGA), and breastfeeding in a population-based cohort study.

The researchers found that, whether continued or discontinued, prescriptions for asthma medications were associated with birth at <32 weeks of gestation, SGA <10th centile, and no breastfeeding (adjusted odds ratios [95 percent confidence intervals], 1.33 [1.10 to 1.61], 1.10 [1.03 to 1.18], and 0.93 [0.87 to 1.01], respectively). There was an association noted for discontinuation of asthma medications in pregnancy with birth at <37 weeks and <32 weeks of gestation (adjusted odds ratios [95 percent confidence intervals], 1.22 [1.06 to 1.41] and 1.53 [1.11 to 2.10], respectively). Except for inhaled corticosteroids and short-acting beta agonists prescribed alone, all medicines examined were associated with SGA <10th centile.

“We acknowledge the difficulties of disentangling the effects of asthma from its management,” the authors write. “Nevertheless, these findings should alert practitioners to the need for targeted care preconception, and during pregnancy and lactation.”

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