Inhaled muscarinic antagonists during pregnancy in women with asthma: case series from a Dutch prospective observational cohort study.

IF 1.3 4区 医学 Q3 ALLERGY
N Kathiravetpillai, A R van Buul, M Ezinga, K Koehorst-Ter Huurne, S A Van Nederveen-Bendien
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Abstract

Introduction: A large proportion of women with asthma experience worsening of asthma during pregnancy. Well-controlled asthma during pregnancy decreases the risk of maternal and fetal complications. Long-acting muscarinic antagonists (LAMAs) are part of treatment guidelines for poorly controlled asthma. There are no clinical safety data available on LAMA and short-acting muscarinic antagonists (SAMAs) use in pregnancy.Objective: The aim was to evaluate asthma control and pregnancy outcomes in pregnant women with asthma using muscarinic antagonists.Methods: A prospective observational cohort of pregnant women with asthma referred to the asthma pregnancy outpatient clinic of the Haga Hospital, between 2018 and 2023, was obtained and retrospectively analyzed. Women using muscarinic antagonists were included. Outcomes were asthma control, asthma exacerbations and pregnancy outcomes.

Results: Fourteen (8.9%) of 158 recruited pregnant women used muscarinic antagonists. Most women had poor asthma control with a mean (±SD) Asthma Control Questionnaire (ACQ) score of 2.4 (±1.3). Six (43%) women experienced an asthma exacerbation. One woman using LAMA throughout pregnancy had pre-eclampsia resulting in preterm birth, low birth weight and neonatal hospitalization. Another child was born with low birth weight and was small for gestational age. Two women developed maternal fever.Conclusions: A minority of women with asthma used muscarinic antagonists during pregnancy. Despite the use of muscarinic antagonists, asthma control remained poor during pregnancy. There were no major adverse pregnancy outcomes or congenital malformations in this case series. Since well-controlled asthma during pregnancy leads to fewer complications, pregnant woman with poorly controlled asthma on inhaled corticosteroid (ICS)/long-acting beta-2-agonist (LABA) should be encouraged to continue add-on asthma medication.

妊娠期哮喘妇女吸入毒蕈碱拮抗剂:荷兰前瞻性观察队列研究的病例系列。
很大一部分患有哮喘的妇女在怀孕期间哮喘会恶化。妊娠期控制良好的哮喘可降低产妇和胎儿并发症的风险。长效毒蕈碱拮抗剂(LAMA)是控制不良哮喘治疗指南的一部分。尚无关于妊娠期使用LAMA和短效毒蕈碱拮抗剂(SAMA)的临床安全性数据。目的是评估使用毒蕈碱拮抗剂的哮喘孕妇的哮喘控制和妊娠结局。获得了2018年至2023年间在Haga医院哮喘妊娠门诊就诊的哮喘孕妇的前瞻性观察队列,并对其进行了回顾性分析。使用毒蕈碱拮抗剂的妇女也包括在内。结果为哮喘控制、哮喘加重和妊娠结局。158名孕妇中有14名(8.9%)使用毒蕈碱拮抗剂。大多数女性哮喘控制较差,哮喘控制问卷(ACQ)平均(±SD)评分为2.4(±1.3)分。6名(43%)女性出现哮喘加重。一名在整个妊娠期间使用LAMA的妇女患有先兆子痫,导致早产、低出生体重和新生儿住院。另一个孩子出生时体重低,胎龄小。两名妇女出现产妇发烧。少数患有哮喘的妇女在怀孕期间使用毒蕈碱拮抗剂。尽管使用了毒蕈碱拮抗剂,妊娠期间哮喘控制仍然很差。在这个病例系列中没有主要的不良妊娠结局或先天性畸形。由于妊娠期哮喘控制良好导致并发症较少,应鼓励使用ICS/LABA治疗哮喘控制不佳的孕妇继续使用附加哮喘药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Asthma
Journal of Asthma 医学-过敏
CiteScore
4.00
自引率
5.30%
发文量
158
审稿时长
3-8 weeks
期刊介绍: Providing an authoritative open forum on asthma and related conditions, Journal of Asthma publishes clinical research around such topics as asthma management, critical and long-term care, preventative measures, environmental counselling, and patient education.
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