Allergy Asthma Proc. 2023 Jan 1;44(1):24-34. doi: 10.2500/aap.2023.44.220077.
Asthma is a frequent and potentially life-threatening disease that complicates many pregnancies. There are extensive data with regard to the diagnosis and treatment of asthma during pregnancy. Medical providers require an up-to-date summary of the critical aspects of asthma management during pregnancy. This review aimed to summarize the available data from clinical trials, cohort studies, expert opinions, and guideline recommendations with regard to asthma in pregnancy. A search through PubMed was conducted by using keywords previously mentioned and MeSH (Medical Subject Headings) terminology. Clinical trials, observational studies, expert opinions, guidelines, and other reviews were included. The quality of the studies was assessed, and data were extracted and summarized. Asthma worsens in ∼40% of pregnant women, which can be associated with maternal and fetal complications. Physiologic changes in the respiratory, cardiovascular, and immune systems during pregnancy play a critical role in the manifestations of asthma. The diagnosis and the treatment of asthma are similar to that of patients who are not pregnant. Nonetheless, concern for fetal malformations, preterm birth, and low birth weight must be considered when managing pregnant patients with asthma. Importantly, cornerstones of the pharmacotherapy of asthma seem to be safe during pregnancy. Asthma in pregnancy is associated with adverse outcomes. Roadblocks to management include associated comorbidities, medication nonadherence, atopy, lack of education, and smoking habits. These need to be acknowledged and addressed for successful asthma management during pregnancy.
哮喘是一种常见且可能危及生命的疾病,会使许多妊娠复杂化。关于妊娠期哮喘的诊断和治疗已有大量数据。医疗服务提供者需要最新的妊娠期哮喘管理关键方面的摘要。本综述旨在总结妊娠期哮喘的临床试验、队列研究、专家意见和指南建议中可获得的数据。通过使用前面提到的关键字和 MeSH(医学主题词)术语在 PubMed 上进行了搜索。纳入了临床试验、观察性研究、专家意见、指南和其他综述。评估了研究的质量,并提取和总结了数据。约 40%的孕妇哮喘会加重,这可能与母婴并发症有关。妊娠期间呼吸、心血管和免疫系统的生理变化在哮喘的表现中起着关键作用。哮喘的诊断和治疗与未怀孕的患者相似。然而,在管理患有哮喘的孕妇时,必须考虑到胎儿畸形、早产和低出生体重的问题。重要的是,哮喘药物治疗的基石在怀孕期间似乎是安全的。妊娠期哮喘与不良结局相关。管理障碍包括相关合并症、药物依从性差、过敏、缺乏教育和吸烟习惯。这些需要得到承认和解决,以实现妊娠期哮喘的成功管理。