Smy Laura, Chan Alvin C H, Bozzo Pina, Koren Gideon
Can Fam Physician. 2014 Sep;60(9):809-12, e433-5.
A healthy woman with mild to moderate asthma came to my clinic today after learning that she was pregnant. She inquired about continuing her inhaled corticosteroid (ICS) medication and whether there would be any risks to her unborn child if she were to do so. What would you advise?
Given the published evidence, ICSs should be continued throughout pregnancy at low to moderate doses sufficient to control asthma symptoms and prevent exacerbations. However, caution must be taken with doses greater than 1000 µg/d (chlorofluorocarbon beclomethasone equivalent), although whether such doses cause adverse effects is currently still questionable. Patient education on proper ICS administration and adherence, including during the first trimester, must be ongoing. Well controlled asthma will reduce the need for higher ICS doses and possible exposure to systemic corticosteroids, and might decrease the risk of adverse pregnancy or perinatal outcomes.
一名患有轻度至中度哮喘的健康女性在得知自己怀孕后今天来到了我的诊所。她询问是否应继续使用吸入性糖皮质激素（ICS）药物，以及如果她这样做，对未出生的孩子是否会有任何风险。你会给出什么建议？
根据已发表的证据，在整个孕期应持续使用低至中等剂量的ICS，剂量要足以控制哮喘症状并预防病情加重。然而，对于剂量大于1000μg/d（氯氟烷倍氯米松等效剂量）的情况必须谨慎，尽管目前尚不清楚此类剂量是否会产生不良反应。必须持续对患者进行关于正确使用ICS及坚持用药的教育，包括在孕早期。哮喘得到良好控制将减少对更高剂量ICS的需求以及可能接触全身用糖皮质激素的情况，并可能降低不良妊娠或围产期结局的风险。
