Algorithm for the management of asthma in pregnant women: a protocol to optimize processes in healthcare

ABSTRACT

Introduction: Asthma is the most common chronic disease in pregnant women. Its evolution during pregnancy could improve, stay the same or worsen, especially in cases where there is a loss of clinical control. This can lead to maternal and fetal hypoxia with serious adverse perinatal outcomes.

Areas covered: This article reviews physiological modifications in pregnancy, effects of pregnancy on asthma, and possible consequences on fetus development. Furthermore, it reviews evidence on assessment and both pharmacological and non-pharmacological management of asthma in pregnant and breastfeeding women as well as in acute exacerbations. Electronic databases, such as PUBMED, were searched for terms pregnan* or perinat* or obstet* and breastfeeding or asthma or wheeze, as well as a book published by the present authors.

Expert commentary: A patient-centered multidisciplinary approach, where the respiratory specialists have a key role in assessing and achieving control, as well as the education interventions for self-monitoring and adherence are at least as important as adequate pharmacological treatment.

KEYWORDS:

• Assessment
• asthma
• breastfeeding
• exacerbation
• management
• pregnancy

Acknowledgments

We would like to thank Dr Pablo Rivas and Content Ed Net for their assistance in providing writing support.

Declaration of interest

E Martinez-Moragon has received speaker’s fees from AstraZeneca, Chiesi, Teva and Novartis, and consulting fees from AIK, AstraZeneca and Boehringer Ingelheim. A Romero-Falcon has received speaker’s fees from AstraZeneca, Pfizer and Novartis. JL Garcia-Rivero has received speaker’s fees from Almirall, Boehringer Ingelheim, Pfizer, AstraZeneca, Chiesi, GlaxoSmithKline, Menarini, Takeda, Teva, Ferrer and Novartis, and consulting fees from AstraZeneca, Boehringer Ingelheim, Esteve, GlaxoSmithKline and Menarini. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

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Funding

This manuscript has not received any funding.