The relationship of asthma medication use to perinatal outcomes

Michael Schatz, Mitchell P. Dombrowski, Robert Wise, Valerija Momirova, Mark Landon, William Mabie, Roger B. Newman, John C. Hauth, Marshall Lindheimer, Steve N. Caritis, Kenneth J. Leveno, Paul Meis, Menachem Miodovnik, Ronald J. Wapner, Richard H. Paul, Michael W. Varner, Mary Jo O'Sullivan, Gary R. Thurnau, Deborah L. Conway

Research output: Contribution to journalArticle

139 Scopus citations

Abstract

Background Maternal asthma has been reported to increase the risk of preeclampsia, preterm deliveries, and lower-birth-weight infants, but the mechanisms of this effect are not defined. Objective We sought to evaluate the relationship between the use of contemporary asthma medications and adverse perinatal outcomes. Methods Asthmatic patients were recruited from the 16 centers of the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network from December 1994 through February 2000. Gestational medication use was determined on the basis of patient history at enrollment and at monthly visits during pregnancy. Perinatal data were obtained at postpartum chart reviews. Perinatal outcome variables included gestational hypertension, preterm births, low-birth-weight infants, small-for-gestational- age infants, and major malformations. Results The final cohort included 2123 asthmatic participants. No significant relationships were found between the use of inhaled β-agonists (n=1828), inhaled corticosteroids (n=722), or theophylline (n=273) and adverse perinatal outcomes. After adjusting for demographic and asthma severity covariates, oral corticosteroid use was significantly associated with both preterm birth at less than 37 weeks' gestation (odds ratio, 1.54; 95% CI, 1.02-2.33) and low birth weight of less than 2500 g (odds ratio, 1.80; 95% CI, 1.13-2.88). Conclusions Use of inhaled β-agonists, inhaled steroids, and theophylline do not appear to increase perinatal risks in pregnant asthmatic women. The mechanism of the association between maternal oral corticosteroid use and prematurity remains to be determined.

Original languageEnglish (US)
Pages (from-to)1040-1045
Number of pages6
JournalJournal of Allergy and Clinical Immunology
Volume113
Issue number6
DOIs
StatePublished - Jun 2004

Keywords

  • Asthma
  • asthma medications
  • inhaled β-agonists
  • inhaled corticosteroids
  • Maternal Fetal Medicine Units
  • MFMU
  • National Institute of Child Health and Human Development
  • NICHD
  • oral corticosteroids
  • perinatal outcomes
  • pregnancy
  • prematurity
  • theophylline

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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  • Cite this

    Schatz, M., Dombrowski, M. P., Wise, R., Momirova, V., Landon, M., Mabie, W., Newman, R. B., Hauth, J. C., Lindheimer, M., Caritis, S. N., Leveno, K. J., Meis, P., Miodovnik, M., Wapner, R. J., Paul, R. H., Varner, M. W., O'Sullivan, M. J., Thurnau, G. R., & Conway, D. L. (2004). The relationship of asthma medication use to perinatal outcomes. Journal of Allergy and Clinical Immunology, 113(6), 1040-1045. https://doi.org/10.1016/j.jaci.2004.03.017