Asthma controller therapy during pregnancy.
OBJECTIVE
This study was undertaken to educate physicians on the safety of asthma controller use during pregnancy.


METHODS
A comprehensive literature search using MEDLINE, the Cochrane Controlled Trials Register and Database of Systematic Reviews, EMBASE, and selected bibliographies identified human gestational studies of asthma controller medications from which maternal and fetal outcomes were obtained. The US Food and Drug Administration (FDA) pregnancy category ratings were identified from product package inserts.


RESULTS
Human gestational studies were identified for the inhaled corticosteroids (ICSs) beclomethasone, budesonide, and triamcinolone and for cromolyn sodium, theophylline, and salmeterol. Human pregnancy data support an FDA Pregnancy Category B rating for budesonide. Pregnancy Category B ratings for cromolyn, nedocromil, montelukast, and zafirlukast are based primarily on safety in animal reproduction studies. ICSs other than budesonide, theophylline, zileuton, and long-acting beta 2 -adrenergic agonists are Pregnancy Category C.


CONCLUSIONS
Human pregnancy data for many asthma controllers are lacking; nonetheless, data support a range of choices among medications rated Pregnancy Category B.
Gluck
Joan C
JC
Florida Center for Allergy and Asthma Care,University of Miami School of Medicine, Miami, Fla, USA.
Gluck
Paul A
PA
D000014:Abnormalities, Drug-Induced; D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects; D000318:Adrenergic beta-Agonists / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy*; D004205:Cromolyn Sodium / Q000009:adverse effects; D005260:Female; D005333:Fetus / Q000187:drug effects*; D006801:Humans; D020024:Leukotriene Antagonists / Q000009:adverse effects; D017835:Nedocromil / Q000009:adverse effects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D013806:Theophylline / Q000009:adverse effects
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D020024:Leukotriene Antagonists; D017835:Nedocromil; D013806:Theophylline; D004205:Cromolyn Sodium