Addressing gaps in asthma management during childbearing age and pregnancy: insights from a survey of Italian physicians and patients.

Background: Asthma is a common condition among women of childbearing age, requiring careful management, particularly during pregnancy. Despite existing guidelines, significant gaps remain in asthma management during pregnancy, notably for women with moderate-to-severe asthma.

Aim: This study aimed to explore the awareness, limitations, and challenges of asthma management during childbearing age and pregnancy from both asthmatic women (AW) and physician perspectives in Italy. Additionally, it sought to identify unmet needs and collect real-life experiences from Italian centers specialized in severe asthma care.

Methods: An anonymous online survey was disseminated through scientific networks and patient associations. Separate questionnaires were developed for doctors and AW by a task force of specialists.

Results: 76 doctors and 54 AW completed the survey, with 70% of AW reporting moderate-to-severe asthma. While most physicians had experience managing asthma in pregnancy, 40% lacked systematic collaboration with gynecologists recognizing the need for integrated care. Despite guidelines supporting asthma medication continuity, 60% of doctors reported discontinuing treatments due to perceived risks. However, surveyed AW generally expressed greater confidence in medication safety. Physicians and AW highlighted the lack of pre-pregnancy counseling, with 55% of AW reporting they had never discussed pregnancy plans when starting asthma treatment. Both groups emphasized the need for improved interdisciplinary collaboration and structured asthma care pathways during pregnancy.

Conclusions: This study reveals significant gaps in asthma management for women of childbearing age and during pregnancy, especially those with moderate-to-severe asthma. Improving outcomes requires better education for patients and healthcare providers, along with a structured multidisciplinary network.