 Many people have posted to ask about whether it is safe to become pregnant
while suffering from asthma, and in particular whether it is safe to use
their asthma medications while pregnant.
The general consensus (from the doctors I have consulted) is that asthmatics
can safely become pregnant without undue worry about whether the mother
and the baby will be all right. Most doctors talk about a "rule of
1/3" by which they mean that roughly 1/3 of all asthmatics get better
while pregnant, 1/3 stay the same, and 1/3 find their asthma is aggravated.
In any event, the bottom line when pregnant is ensuring that the baby receives
sufficient oxygen - and medications should be used as appropriate to control
the asthma and protect mother and child. It is inadvisable to stop or reduce
asthma medication solely because of the pregnancy without careful supervision,
as this can lead to poorly controlled asthma, unnecessary ER visits, and
poor outcome for the baby and/or mother.
Most commonly-used asthma medications appear to be safe when used in pregnancy;
notable exceptions include the combination pills (Marax, Tedral etc) and
those containing iodine (e.g. Theo-Organidin). Many people are concerned
in particular with the use of inhaled, intranasal, and/or oral steroids
but it has been my experience that most doctors are quite willing to use
these as needed, especially the inhaled and intranasal steroids.
There are choices in most classes of drugs, e.g., the bronchodilators, and
many doctors will elect to put their patients on those drugs with the longest
history of use in pregnant women - the assumption is that the longer a drug
has been in use, the likelier it is that any problems would have become
evident. For this reason, beclomethasone (Beclovent, Vanceril) is the preferred
inhaled corticosteroid. Cromolyn Sodium (Nasalcrom, Intal) also appears
to be safe for use in pregnancy.
In addition, if you need to use systemic steroids for a brief flareup, old
concerns over fetal abnormalities (cleft palate etc.) appear to be less
worrisome; I know of one case in which a woman used prednisone for something
other than asthma for several months while pregnant and her baby had no
problems.
Antibiotics may be used if needed; there are some such as tetracycline which
should be avoided but others (such as penicillin) appear to be safe.
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