ACUTE ASTHMA DURING PREGNANCY

Background - Acute asthma during pregnancy is potentially dangerous to the fetus. The aim of this study was to investigate the effect of an acute attack of asthma during pregnancy on the course of pregnancy or delivery, or the health of the newborn infant, and to identify undertr eatment as a possible cause of the exacerbations. Methods - Five hundr ed and four pregnant asthmatic subjects were prospectively followed an d treated. The data on 47 patients with an attack of asthma during pre gnancy were compared with those of 457 asthmatics with no recorded acu te exacerbation and with 237 healthy parturients. Results - Of 504 ast hmatics, 177 patients were not initially treated with inhaled corticos teroids. Of these, 17% had an acute attack compared with only 4% of th e 257 patients who had been on inhaled anti-inflammatory treatment fro m the start of pregnancy. There were no differences between the groups as to length of gestation, length of the third stage of labour, or am ount of haemorrhage after delivery. No differences were observed betwe en pregnancies with and without an exacerbation with regard to relativ e birth weight, incidence of malformations, hypoglycaemia, or need for phototherapy for jaundice during the neonatal period. Conclusions - P atients with inadequate inhaled anti-inflammatory treatment during pre gnancy run a higher risk of suffering an acute attack of asthma than t hose treated with an anti-inflammatory agent. However, if the acute at tack of asthma is relatively mild and promptly treated, it does not ha ve a serious effect on the pregnancy, delivery, or the health of the n ewborn infant.