The safety of asthma treatment and management strategies in pregnancy.

Abstract

Introduction: Poor asthma control in pregnancy is associated with worse maternal and fetal outcomes. Despite this, many patients and providers opt not to continue treatment in pregnancy, largely due to fear of teratogenicity. The goal of this review is to inform providers about the safety of asthma medication in pregnancy as well as strategies for encouraging patients to adhere to these medications.

Areas covered: To prepare this narrative review article, we performed a database search using PubMed, Cochrane Library, Embase, Web of Science, and Google Scholar to obtain a broad range of clinical studies, systematic reviews, and meta-analyses related to asthma management during pregnancy. Search terms included asthma, pregnan*, treat*, therap*, manage*, and comorbid* with Boolean operators used to refine the search. Studies were limited to those published in the English language from 2000 to 2025.

Expert opinion: Most classes of medications used to treat asthma have reassuring safety data for use in pregnancy. Additional data are needed to assess the use of biologics in pregnancy, which have become a cornerstone of management for non-pregnant patients with severe asthma. Routine visits with providers and identifying treatable traits can also improve outcomes in these patients.