If Mom Is Not Breathing, Neither Is Baby
A common breathing problem is also one of the most serious chronic medical conditions complicating pregnancy. According to recent research and despite specific guidelines and recommendations advocating for aggressive asthma management, healthcare providers treat asthma attacks in pregnant women differently than in non-pregnant women.
Researchers at The Ohio State University Medical Center sought to determine if pregnant women who come to the emergency department with acute asthma symptoms receive the same anti-inflammatory medicines and steroids to treat flare-ups as nonpregnant women.
“We found that pregnant asthmatics were less likely to receive steroids while in the emergency department or were not discharged with a prescription for steroids if they presented with a mild or moderate exacerbation,” says Dr. Jennifer McCallister, an asthma expert at Ohio State’s Medical Center. “This potentially increases the risk of complications to the mother and her unborn child.
Women who were not treated appropriately during their first trip to the emergency department were nearly four times as likely to return with persistent asthma symptoms within two weeks.
“Some physicians are reluctant to give pregnant asthmatic patients steroids out of fear of the impact it may have on the unborn child. However, those same women who were not treated appropriately during their first trip were nearly four times as likely to return to the emergency department with persistent asthma symptoms within two weeks,” adds Dr. McCallister.
Adverse pregnancy outcomes can be attributed to poor asthma control, and severe maternal asthma has been linked to an increased risk of infant death, preeclampsia, premature birth, and low birth weight.
“Controlling asthma during pregnancy is far safer for the pregnant patient and her unborn child, than not doing so,” says Dr. McCallister.
For the study, researchers analyzed the medical records of 123 pregnant women and 123 non-pregnant women who were treated for asthma in the emergency department. Only 50.8 percent of pregnant women received steroids, compared to 72.4 percent of non-pregnant women. Similarly, 69.2 percent of non-pregnant women received a prescription for steroids upon discharge, yet only 41.3 percent of pregnant women were discharged with a steroid prescription.
In addition, the level of severity for asthma attacks influenced therapy. Pregnant women with mild or moderate symptoms were less likely to be prescribed steroids at discharge from the emergency department, compared to non-pregnant women.
“It is extremely important to the improvement of pregnancy outcomes that there is well-controlled, on-going asthma management and [that] treatments of exacerbations are aggressive during pregnancy,” Dr. McCallister adds.
This article was originally published in Coping® with Allergies & Asthma magazine, July/August 2010.