Asthma treatment guidelines emphasize the importance of maintaining asthma control during pregnancy because the risks of uncontrolled asthma are far greater than the risks associated with necessary asthma medications. Budesonide is one of the inhaled corticosteroids recommended for use during pregnancy. It is particularly a good choice for those women who require high-dose inhaled corticosteroids because of its ability to maximize adherence and minimize systemic effects.

To determine the effect budesonide has on pregnancy outcomes, Ensio Norjavaara, MD, PhD, Göteborg Pediatric Growth Research Centre, Sweden and colleagues compared mothers reporting usage of asthma medications with those who reported no usage. Researchers took their data from the Swedish Medical Birth Register, which includes 99% of the births in Sweden.

Medication During Pregnancy

• 7,719 used asthma medications other than inhaled or oral corticosteroids
• 3,364 used only inhaled corticosteroids
• 2,968 used budesonide, 207 during the entire pregnancy
• 103 used both budesonide and an oral corticosteroid

The mothers who reported taking budesonide to control their asthma gave birth to babies of normal gestational age, birth weight and length. Those mothers also showed no increased rate of still births or multiple births as well.

The JACI study is the largest to date observing the use of inhaled corticosteroids and pregnancy outcomes. Women who are pregnant are often reluctant to take inhaled asthma medication because of the general fear of negative effects on the fetus. This may in turn increase the effect of asthma on the fetus and increase the risk of adverse outcomes such as higher rates of prematurity, lower birth weight and perinatal death. The current study reassures previous findings that inhaled corticosteroid therapy has no negative effect on the outcome of pregnancy.

AAAAI News Release