HAC (Russian)
RSCI (Russian)
Ulrichsweb (Ulrich’s Periodicals Directory)
Scientific Indexing Services

Asthma and pregnancy

DOI: https://doi.org/10.29296/25877305-2024-01-01

O. Lavrova, MD, PhD; Professor M. Petrova, MD, PhD
I.P. Pavlov First Saint Petersburg State Medical University

Features of the course and treatment of bronchial asthma during pregnancy have been the subject of close attention of researchers in recent decades. Physiological changes and the nature of treatment of bronchial asthma during pregnancy determine the degree of control of the disease, which, in turn, affects the incidence of complications of pregnancy and childbirth, and the health of the newborn. The presented literature review analyzes recent publications on this issue.

pregnancy complications.

  1. Wu T.D., Brigham E.P., McCormack M.C. Asthma in the Primary Care Setting. Med Clin North Am. 2019; 103 (3): 435–52. DOI: 10.1016/j.mcna.2018.12.004
  2. Murphy V.E., Wang G., Namazy J.A. et al. The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta-analysis. BJOG. 2013; 120 (7): 812–22. DOI: 10.1111/1471-0528.12224
  3. Grosso A., Locatelli F., Gini E. et al. The course of asthma during pregnancy in a recent, multicase-control study on respiratory health. Allergy Asthma Clin Immunol. 2018; 14: 16. DOI: 10.1186/s13223-018-0242-0
  4. Namazy J.A., Schatz M. Contemporary management and treatment strategies for asthma during pregnancy. Expert Rev Respir Med. 2021; 15 (9): 1149–57. DOI: 10.1080/17476348.2021.1935243
  5. Ibrahim W.H., Rasul F., Ahmad M. et al. Asthma knowledge, care, and outcome during pregnancy: The QAKCOP study. Chron Respir Dis. 2019; 16: 1479972318767719. DOI: 10.1177/1479972318767719
  6. Tan E.K., Tan E.L. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013; 27 (6): 791–802. DOI: 10.1016/j.bpobgyn.2013.08.001
  7. Annamraju H., Mackillop L. Respiratory disease in pregnancy. Obstet Gynaecol Reprod Med. 2017; 27 (4): 105–11. DOI: 10.1016/j.ogrm.2017.01.011
  8. Mehta N., Chen K., Hardy E. et al. Respiratory disease in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2015; 29 (5): 598–611. DOI: 10.1016/j.bpobgyn.2015.04.005
  9. Kourtis A.P., Read J.S., Jamieson D.J. Pregnancy and infection. N Engl J Med. 2014; 370 (23): 2211–8. DOI: 10.1056/NEJMra1213566
  10. National Asthma Council Australia. Australian asthma Handbook, 2019. Available at: https://www.asthmahandbook.org.au/populations/pregnant-women/preconception
  11. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2023. Available at: https://ginasthma.org/gina-reports
  12. Kher S., Mota P. Maternal asthma: Management strategies. Cleve Clin J Med. 2017; 84 (3): 296–302. DOI: 10.3949/ccjm.84a.15046
  13. van Nederveen-Bendien S.A., van Oord-Bosselaar S.R.J. Pharmacological treatment of asthma during pregnancy. Ned Tijdschr Geneeskd. 2018; 162: D2099.
  14. Wang H., Li N., Huang H. Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety. Can Respir J. 2020; 2020: 9046842. DOI: 10.1155/2020/9046842
  15. Robijn A.L., Murphy V. E., Gibson P.G. Recent developments in asthma in pregnancy. Curr Opin Pulm Med. 2019; 25 (1): 11–7. DOI: 10.1097/MCP.0000000000000538
  16. Stoup T., Chenivesse C. Management of asthma during pregnancy. Rev Mal Respir. 2021; 38 (6): 626–37. DOI: 10.1016/j.rmr.2021.04.010
  17. Blais L., Beauchesne M.F., Lemière C. et al. High doses of inhaled corticosteroids during the first trimester of pregnancy and congenital malformations. Allergy Clin Immunol. 2009; 124 (6): 1229–34.e4. DOI: 10.1016/j.jaci.2009.09.025
  18. Cossette B., Forget A., Beauchesne M.-F. et al. Impact of maternal use of asthma-controller therapy on perinatal outcomes. Thorax. 2013; 68 (8): 724–30. DOI: 10.1136/thoraxjnl-2012-203122
  19. Palmsten K., Bandoli G., Vazquez-Benitez G. et al. Oral corticosteroid use during pregnancy and risk of preterm birth. Rheumatology (Oxford). 2020; 59 (6): 1262–71. DOI: 10.1093/rheumatology/kez405
  20. Namazy J. A., Murphy V. E., Powell H. et al. Effects of asthma severity, exacerbations and oral corticosteroids on perinatal outcomes. Eur Respir J. 2013; 41 (5): 1082–90. DOI: 10.1183/09031936.00195111
  21. Martel M.-J., Rey É., Beauchesne M.-F. et al. Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study. BMJ. 2005; 330 (7485): 230. DOI: 10.1136/bmj.38313.624352.8f
  22. Zhang D., Liu H., Zeng J. et al. Glucocorticoid exposure in early placentation induces preeclampsia in rats via interfering trophoblast development. Gen Comp Endocrinol. 2016; 225: 61–70. DOI: 10.1016/j.ygcen.2015.09.019
  23. Eltonsy S., Kettani F.-Z., Blais L. Beta2-agonists use during pregnancy and perinatal outcomes: a systematic review. Respir Med. 2014; 108 (1): 9–33. DOI: 10.1016/j.rmed.2013.07.009
  24. Garne E., Hansen A. V., Morris J. et al. Use of asthma medication during pregnancy and risk of specific congenital anomalies: a European case-malformed control study. J Allergy Clin Immunol. 2015; 136 (6): 1496–502. DOI: 10.1016/j.jaci.2015.05.043
  25. Blais L., Kettani F.-Z., Forget A. et al. Long-acting β2-agonists and risk of hypertensive disorders of pregnancy: a cohort study. J Allergy Clin Immunol. 2018; 6 (2): 555–61. DOI: 10.1016/j.jaip.2017.07.004
  26. Soler X., Ramsdell J. Anticholinergics/antimuscarinic drugs in asthma. Curr Allergy Asthma Rep. 2014; 14 (12): 484. DOI: 10.1007/s11882-014-0484-y
  27. Quirce S., Dominguez-Ortega J., Barranco P. Anticholinergics for treatment of asthma. J Investig Allergol Clin Immunol. 2015; 25 (25): 84–5.
  28. Rocklin R.E. Asthma, asthma medications and their effects on maternal/fetal outcomes during pregnancy. Reprod Toxicol. 2011; 32 (2): 189–97. DOI: 10.1016/j.reprotox.2011.05.023
  29. Castillo J.R., Peters S.P., Busse W.W. Asthma exacerbations: pathogenesis, prevention, and treatment. J Allergy Clin Immunol. 2017; 5 (4): 918–27. DOI: 10.1016/j.jaip.2017.05.001
  30. Tamada T., Ichinose M. Leukotriene Receptor Antagonists and Antiallergy Drugs. Handb Exp Pharmacol. 2017; 237: 153–69. DOI: 10.1007/164_2016_72
  31. Nelsen L.M., Shields K.E., Cunningham M.L. et al. Congenital malformations among infants born to women receiving montelukast, inhaled corticosteroids, and other asthma medications. J Allergy Clin Immunol. 2012; 129 (1): 251–4. DOI: 10.1016/j.jaci.2011.09.003
  32. Kiernan E., Jones K.L. Medications that cause fetal anomalies and possible prevention strategies. Clin Perinatol. 2019; 46 (2): 203–13. DOI: 10.1016/j.clp.2019.02.003
  33. Namazy J., Cabana M.D., Scheuerle A.E. et al. The Xolair Pregnancy Registry (EXPECT): the safety of omalizumab use during pregnancy. J Allergy Clin Immunol. 2015; 135 (2): 407–12. DOI: 10.1016/j.jaci.2014.08.025
  34. Kelly W., Massoumi A., Lazarus A. Asthma in pregnancy: physiology, diagnosis, and management. Postgrad Med. 2015; 127 (4): 349–58. DOI: 10.1080/00325481.2015.1016386
  35. Sattler C., Garcia G., Humbert M. Novel targets of omalizumab in asthma. Curr Opin Pulm Med. 2017; 23 (1): 56–61. DOI: 10.1097/mcp.0000000000000340
  36. Bel E.H., Wenzel S.E., Thompson P.J. et al. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med. 2014; 371 (13): 1189–97. DOI: 10.1056/nejmoa1403291
  37. Castro M., Mathur S., Hargreave F. et al. Reslizumab for poorly controlled, eosinophilic asthma. Am J Resp Crit Care Med. 2011; 184 (10): 1125–32. DOI: 10.1164/rccm.201103-0396oc
  38. Abramowicz M., Zuccotti G., Pflomm J.M. Benralizumab (Fasenra) for severe eosinophilic asthma. JAMA. 2018; 319 (14): 1501–2. DOI: 10.1001/jama.2018.3609
  39. Pitsios C., Demoly P., Bilò M. B. et al. Clinical contraindications to allergen immunotherapy: an EAACI position paper. Allergy. 2015; 70 (8): 897–909. DOI: 10.1111/all.12638
  40. Shaikh W.A., Shaikh S.W. A prospective study on the safety of sublingual immunotherapy in pregnancy. Allergy. 2012; 67 (6): 741–3. DOI: 10.1111/j.1398-9995.2012.02815.x
  41. Murphy V.E., Jensen M.E., Gibson P.G. Asthma during Pregnancy: Exacerbations, Management, and Health Outcomes for Mother and Infant. Semin Respir Crit Care Med. 2017; 38 (2): 160–73. DOI: 10.1055/s-0037-1600906
  42. Shebl E., Chakraborty R.K. Asthma in Pregnancy. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2023.
  43. Бронхиальная астма. Клинические рекомендации. 2021 [Bronkhial'naya astma. Klinicheskie rekomendatsii. 2021 (in Russ.)]. URL: https://spulmo.ru/upload/kr/BA_2021.pdf
  44. Ali Z., Nilas L., Ulrik C.S. Determinants of low risk of asthma exacerbation during pregnancy. Clin Exp Allergy. 2018; 48 (1): 23–8. DOI: 10.1111/cea.13033
  45. Murphy V.E., Powell H., Wark P.A.B. et al. A prospective study of respiratory viral infection in pregnant women with and without asthma. Chest. 2013; 144 (2): 420–7. DOI: 10.1378/chest.12-1956
  46. Majithia R., Johnson D.A. Are proton pump inhibitors safe during pregnancy and lactation? Evidence to date. Drugs. 2012; 72 (2): 171–9. DOI: 10.2165/11597290-000000000-0000
  47. Marchi J., Berg M., Dencker A. et al. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes Rev. 2015; 16 (8): 621–38. DOI: 10.1111/obr.12288