title: The relationship of asthma medication use to perinatal outcomes.
abstract: BACKGROUND
  Maternal asthma has been reported to increase the risk of preeclampsia, preterm deliveries, and lower-birth-weight infants, but the mechanisms of this effect are not defined.
  
  
  OBJECTIVE
  We sought to evaluate the relationship between the use of contemporary asthma medications and adverse perinatal outcomes.
  
  
  METHODS
  Asthmatic patients were recruited from the 16 centers of the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network from December 1994 through February 2000. Gestational medication use was determined on the basis of patient history at enrollment and at monthly visits during pregnancy. Perinatal data were obtained at postpartum chart reviews. Perinatal outcome variables included gestational hypertension, preterm births, low-birth-weight infants, small-for-gestational-age infants, and major malformations.
  
  
  RESULTS
  The final cohort included 2123 asthmatic participants. No significant relationships were found between the use of inhaled beta-agonists (n=1828), inhaled corticosteroids (n=722), or theophylline (n=273) and adverse perinatal outcomes. After adjusting for demographic and asthma severity covariates, oral corticosteroid use was significantly associated with both preterm birth at less than 37 weeks' gestation (odds ratio, 1.54; 95% CI, 1.02-2.33) and low birth weight of less than 2500 g (odds ratio, 1.80; 95% CI, 1.13-2.88).
  
  
  CONCLUSIONS
  Use of inhaled beta-agonists, inhaled steroids, and theophylline do not appear to increase perinatal risks in pregnant asthmatic women. The mechanism of the association between maternal oral corticosteroid use and prematurity remains to be determined.
authors.affiliation: Allergy Department, Kaiser Permanente Medical Center, 7060 Clairemont Mesa Boulevard, San Diego, CA 92111, USA. michael.x.schatz@kp.org
authors.forename: Michael
authors.initials: M
authors.lastname: Schatz
authors.forename: Mitchell P
authors.initials: MP
authors.lastname: Dombrowski
authors.forename: Robert
authors.initials: R
authors.lastname: Wise
authors.forename: Valerija
authors.initials: V
authors.lastname: Momirova
authors.forename: Mark
authors.initials: M
authors.lastname: Landon
authors.forename: William
authors.initials: W
authors.lastname: Mabie
authors.forename: Roger B
authors.initials: RB
authors.lastname: Newman
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.forename: Marshall
authors.initials: M
authors.lastname: Lindheimer
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.forename: Paul
authors.initials: P
authors.lastname: Meis
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Richard H
authors.initials: RH
authors.lastname: Paul
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Gary R
authors.initials: GR
authors.lastname: Thurnau
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Conway
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D001724:Birth Weight / Q000187:drug effects; D015331:Cohort Studies; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000139:chemically induced; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents