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Inhaled Steroids Safe During Pregnancy

Drugs Improve Asthma Symptoms, Don't Slow Babies' Growth
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March 11, 2003 (Denver) -- Expectant mothers have to be cautious about what medications they use, but a new study suggests that when it comes to asthma, inhaled steroids can be taken safely.

Inhaled corticosteroids are commonly used for asthma treatment, but their safety during pregnancy has not been established. What's more, previous studies suggest that corticosteroids taken by mouth (which give a much stronger dose than when inhaled) may slow fetal growth.

However, not taking asthma medications as prescribed during pregnancy can be worse than not taking them at all, said Jennifer Namazy, MD, with the Scripps Clinic, La Jolla, California during a news conference. "If a mother can't breathe, that's really going to harm the baby." Namazy and colleagues presented their findings at the 60th meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI) on Monday. The study was funded by Aventis Pharmaceuticals, the maker of the inhaler Nasacort.

In the largest study of its kind, the researchers collected information from 475 allergic and asthmatic pregnant women. Each of the women used one or more of five asthma inhalers: beclomethasone (Beclovent, Qvar, and Vanceril), Flovent, Nasacort, Pulmicort, and AeroBid.

The researchers then determined the birth weight of 392 babies born to the study participants. Any weight that was lower than 10% on a reference scale of U.S. birth weights was considered "small for gestational age."

About 7% of the babies born to mothers who used inhaled steroids were small for gestational age, compared with 10% born in the U.S. overall, suggesting that inhaled corticosteroids did not have any effect.

But as with previous studies, high-dose oral corticosteroids did appear to lower birth weight. Just under a third of the study subjects took oral corticosteroids, and these patients were more likely to deliver small infants (10.7%) compared with those not taking them (4.9%), although even birth weights of oral corticosteroid users came close to the national rate for low birth weights.

"These data suggest that inhaled corticosteroids are safe and that pregnant women should aim to control their asthma by controlling their environment and taking their medications when required," Namazy said.

"This is a very exciting study," said Kathleen A. Sheerin, MD, an allergist in Atlanta and vice chair of the AAAAI's public education committee.

According to Sheerin, women have had a lot of fear that stops them from taking their asthma medications. "We are always telling women who are pregnant that we think inhaled corticosteroids are safe," she told WebMD, "and now, finally, we can tell them that they are safe."

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