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Canadian Journal of Respiratory, Critical Care, and Sleep Medicine
Revue canadienne des soins respiratoires et critiques et de la médecine du sommeil
Volume 2, 2018 - Issue 3
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Clinical Respiratory Review

Asthma and pregnancy: A review of management strategies with an emphasis on medication safety and outcomes

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References

  • GINA. Global Strategy for Asthma Management and Prevention. 2015.
  • Murphy V, Gibson P, Smith R, et al.. Asthma during pregnancy: mechanisms and treatment implications. Eur Respir J. 2005;25(4):731–50. doi:10.1183/09031936.05.00085704.
  • Namazy J, Schatz M. Pregnancy and asthma: recent developments. Curr Opin Pulm Med. 2005;11(1):56–60. doi:10.1097/01.mcp.0000148568.20273.f5.
  • Tan K, Thomson N. Asthma in pregnancy. Am J Med. 2000;109(9):727–33. doi:10.1016/S0002-9343(00)00615-X.
  • Alexander S, Dodds L, Armson B. Perinatal outcomes in women with asthma during pregnancy. Obstet Gynecol. 1998;92(3):435–40.
  • Blais M. Management of rhinitis and asthma in pregnancy. Ann Allergy Asthma Immunol. 2003;90(Suppl 3):16–22. doi:10.1016/S1081-1206(10)61655-9.
  • Liccardi G, Cazzola M, Canonica G, et al.. General strategy for the management of bronchial asthma in pregnancy. Respir Med. 2003;97(7):778–89. doi:10.1016/S0954-6111(03)00031-3.
  • Demoly P, Piette V, Daures J. Asthma therapy during pregnancy. Expert Opin Pharmacother. 2003;4(7):1019–23. doi:10.1517/14656566.4.7.1019.
  • Kwon H, Belanger K, Bracken M. Asthma prevalence among pregnant and childbearing-aged women in the United States: Estimates from national health surveys. Ann Epidemiol. 2003;13(5):317–24. doi:10.1016/S1047-2797(03)00008-5.
  • Kwon H, Triche E, Belanger K, et al.. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am. 2006;26(1):29–62. doi:10.1016/j.iac.2005.11.002.
  • Tata L, Lewis S, McKeever T, et al. A comprehensive analysis of adverse obstetric and pediatric complications in women with asthma. Am J Respir Crit Care Med. 2007;175(10):991–7. doi:10.1164/rccm.200611-1641OC.
  • Murphy V, Gibson P. Asthma in pregnancy. Clin Chest Med. 2011;32(1):93–110, ix. doi:10.1016/j.ccm.2010.10.001.
  • Otsuka H, Narushima M, Suzuki H. Assessment of inhaled corticosteroid therapy for asthma treatment during pregnancy. Allergol Int. 2005;54:381–86. doi:10.2332/allergolint.54.381.
  • Wen SW, Demissie K, Liu S. Adverse outcomes in pregnancies of asthmatic women: results from a Canadian population. Ann Epidemiol. 2001;11(1):7–12. doi:10.1016/S1047-2797(00)00077-6.
  • Vanders RL, Murphy VE. Maternal complications and the management of asthma in pregnancy. Womens Health (Lond Engl). 2015;11(2):183–91. doi:10.2217/WHE.14.69.
  • Cooper BG. An update on contraindications for lung function testing. Thorax. 2011;66:714–723 doi:10.1136/thx.2010.139881.
  • Cousins L. Fetal oxygenation, assessment of fetal well-being, and obstetric management of the pregnant patient with asthma. J Allergy Clin Immunol. 1999;103(2Pt 2):S343–9. doi:10.1016/S0091-6749(99)70260-5.
  • Gluck JC. The change of asthma course during pregnancy. Clin Rev Allergy Immunol. 2004;26(3):171–80.
  • Prowse CM, Gaensler EA. Respiratory and acid-base changes during pregnancy. Anesthesiology. 1965;26:381–92. doi:10.1097/00000542-196507000-00003.
  • Milne JA, Mills RJ, Howie AD, et al.. Large airways function during normal pregnancy. Br J Obstet Gynaecol. 1977;84(6):448–51. doi:10.1111/j.1471-0528.1977.tb12621.x.
  • Sroczynski T. Evaluation of respiratory tract function in healthy women in the last month of uncomplicated pregnancy. Ann Acad Med Stetin. 2002;48:331–50.
  • Grindheim G, Toska K, Estensen ME, et al.. Changes in pulmonary function during pregnancy: a longitudinal cohort study. BJOG. 2012;119(1):94–101. doi:10.1111/j.1471-0528.2011.03158.x.
  • Wise RA, Polito AJ, Krishnan V. Respiratory physiologic changes in pregnancy. Immunol Allergy Clin North Am. 2006;26(1):1–12. doi:10.1016/j.iac.2005.10.004.
  • Tavakolpour S, Rahimzadeh G. New insights into the management of patients with autoimmune diseases or inflammatory disorders during pregnancy. Scand J Immunol. 2016;84(3):146–9. doi:10.1111/sji.12453.
  • Bohacs A, Bikov A, Ivancso I, et al. Relationship of circulating C5a and complement factor H levels with disease control in pregnant women with Asthma. Respir Care. 2016;61(4):502–9. doi:10.4187/respcare.04339.
  • Gluck JC, Gluck PA. The effect of pregnancy on the course of asthma. Immunol Allergy Clin North Am. 2006;26(1):63–80. doi:10.1016/j.iac.2005.10.008.
  • Schatz M, Dombrowski MP, Wise R, et al. Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol. 2003;112(2):283–8. doi:10.1067/mai.2003.1516.
  • Schatz M, Harden K, Forsythe A, et al. The course of asthma during pregnancy, post partum, and with successive pregnancies: a prospective analysis. J Allergy Clin Immunol. 1988;81(3):509–17. doi:10.1016/0091-6749(88)90187-X.
  • Murphy VE, Clifton VL, Gibson PG. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax. 2006;61(2):169–76. doi:10.1136/thx.2005.049718.
  • Murphy VE, Gibson P, Talbot PI, et al.. Severe asthma exacerbations during pregnancy. Obstet Gynecol. 2005;106(5Pt 1):1046–54. doi:10.1097/01.AOG.0000185281.21716.02.
  • Stenius-Aarniala BS, Hedman J, Teramo KA. Acute asthma during pregnancy. Thorax. 1996;51(4):411–4. doi:10.1136/thx.51.4.411.
  • Kim S, Kim J, Park SY, et al. Effect of pregnancy in asthma on health care use and perinatal outcomes. J Allergy Clin Immunol. 2015;136(5):1215–23 e6. doi:10.1016/j.jaci.2015.04.043.
  • Blais L, Forget A. Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic women. J Allergy Clin Immunol. 2008;121(6):1379–84, 84 e1. doi:10.1016/j.jaci.2008.02.038.
  • Blais L, Kettani FZ, Forget A, et al.. Asthma exacerbations during the first trimester of pregnancy and congenital malformations: revisiting the association in a large representative cohort. Thorax. 2015;70(7):647–52. doi:10.1136/thoraxjnl-2014-206634.
  • Murphy VE, Wang G, Namazy JA, et al. The risk of congenital malformations, perinatal mortality and neonatal hospitalisation among pregnant women with asthma: a systematic review and meta-analysis. BJOG. 2013;120(7):812–22. doi:10.1111/1471-0528.12224.
  • Ali Z, Nilas L, Ulrik CS. Low risk of adverse obstetrical and perinatal outcome in pregnancies complicated by asthma: A case control study. Respir Med. 2016;120:124–30. doi:10.1016/j.rmed.2016.10.004.
  • Blais L, Kettani FZ, Elftouh N, et al.. Effect of maternal asthma on the risk of specifcic congenital malformations: a population based cohort study. Birth Defects Res A Clin Mol Teratol. 2010;88:216–222.
  • Murphy VE, Namazy JA, Powell H, et al. A meta-analysis of adverse perinatal outcomes in women with asthma. BJOG. 2011;118(11):1314–23. doi:10.1111/j.1471-0528.2011.03055.x.
  • NAEPP. National Asthma Education and Prevention Program. National Heart Lung, and Blood Institute. Managing special situations-pregnancy. Washington, DC: US Department of Health and Human Services; 2007.
  • ACOG. The use of newer asthma and allergy medications during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) and The American College of Allergy, Asthma and Immunology (ACAAI). Ann Allergy Asthma Immunol. 2000;84(5):475–80. doi:10.1016/S1081-1206(10)62505-7.
  • SIGN. Asthma in pregnancy. British Guidelines on the Management of Asthma 2012; https://www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-guideline-on-the-management-of-asthma/. Accessed December 15, 2015.
  • Tata LJ, Lewis SA, McKeever TM, et al. Effect of maternal asthma, exacerbations and asthma medication use on congenital malformations in offspring: a UK population-based study. Thorax. 2008;63(11):981–7. doi:10.1136/thx.2008.098244.
  • Martel MJ, Rey E, Beauchesne MF, et al. Use of short-acting beta2-agonists during pregnancy and the risk of pregnancy-induced hypertension. J Allergy Clin Immunol. 2007;119(3):576–82. doi:10.1016/j.jaci.2006.10.034.
  • Schatz M, Dombrowski MP, Wise R, et al. The relationship of asthma medication use to perinatal outcomes. J Allergy Clin Immunol. 2004;113(6):1040–5. doi:10.1016/j.jaci.2004.03.017.
  • Schatz M, Zeiger RS, Harden KM, et al. The safety of inhaled beta-agonist bronchodilators during pregnancy. J Allergy Clin Immunol. 1988;82(4):686–95. doi:10.1016/0091-6749(88)90984-0.
  • Eltonsy S, Forget A, Blais L. Beta2-agonists use during pregnancy and the risk of congenital malformations. Birth Defects Res A Clin Mol Teratol. 2011;91(11):937–47. doi:10.1002/bdra.22850.
  • Bracken MB, Triche EW, Belanger K, et al.. Asthma symptoms, severity, and drug therapy: a prospective study of effects on 2205 pregnancies. Obstet Gynecol. 2003;102(4):739–52.
  • Bakhireva LN, Jones KL, Schatz M, et al.. Asthma medication use in pregnancy and fetal growth. J Allergy Clin Immunol. 2005;116(3):503–9. doi:10.1016/j.jaci.2005.05.027.
  • Tamasi L, Somoskovi A, Muller V, et al. A population-based case-control study on the effect of bronchial asthma during pregnancy for congenital abnormalities of the offspring. J Asthma. 2006;43(1):81–6. doi:10.1080/02770900500448803.
  • Lin S, Munsie JP, Herdt-Losavio ML, et al. Maternal asthma medication use and the risk of gastroschisis. Am J Epidemiol. 2008;168(1):73–9. doi:10.1093/aje/kwn098.
  • Kallen B, Otterblad Olausson P. Use of anti-asthmatic drugs during pregnancy. 3. Congenital malformations in the infants. Eur J Clin Pharmacol. 2007;63(4):383–8. doi:10.1007/s00228-006-0259-z.
  • Schatz M, Leibman C. Inhaled corticosteroid use and outcomes in pregnancy. Ann Allergy Asthma Immunol. 2005;95(3):234–8. doi:10.1016/S1081-1206(10)61219-7.
  • Wendel PJ, Ramin SM, Barnett-Hamm C, et al.. Asthma treatment in pregnancy: a randomized controlled study. Am J Obstet Gynecol. 1996;175(1):150–4. doi:10.1016/S0002-9378(96)70265-X.
  • Lim A, Stewart K, Konig K, et al.. Systematic review of the safety of regular preventive asthma medications during pregnancy. Ann Pharmacother. 2011;45(7-8):931–45. doi:10.1345/aph.1P764.
  • Rahimi R, Nikfar S, Abdollahi M. Meta-analysis finds use of inhaled corticosteroids during pregnancy safe: a systematic meta-analysis review. Hum Exp Toxicol. 2006;25(8):447–52. doi:10.1191/0960327106het647oa.
  • Martel MJ, Rey E, Beauchesne MF, et al. Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study. BMJ. 2005;330(7485):230. doi:10.1136/bmj.38313.624352.8F.
  • Breton MC, Beauchesne MF, Lemiere C, et al.. Risk of perinatal mortality associated with inhaled corticosteroid use for the treatment of asthma during pregnancy. J Allergy Clin Immunol. 2010;126(4):772–7 e2. doi:10.1016/j.jaci.2010.08.018.
  • Norjavaara E, de Verdier MG. Normal pregnancy outcomes in a population-based study including 2,968 pregnant women exposed to budesonide. J Allergy Clin Immunol. 2003;111(4):736–42. doi:10.1067/mai.2003.1340.
  • Namazy J, Schatz M, Long L, et al. Use of inhaled steroids by pregnant asthmatic women does not reduce intrauterine growth. J Allergy Clin Immunol. 2004;113(3):427–32. doi:10.1016/j.jaci.2003.11.046.
  • Cossette B, Forget A, Beauchesne MF, et al. Impact of maternal use of asthma-controller therapy on perinatal outcomes. Thorax. 2013;68(8):724–30. doi:10.1136/thoraxjnl-2012-203122.
  • Blais L, Beauchesne MF, Rey E, et al.. Use of inhaled corticosteroids during the first trimester of pregnancy and the risk of congenital malformations among women with asthma. Thorax. 2007;62(4):320–8. doi:10.1136/thx.2006.062950.
  • Blais L, Beauchesne MF, Lemiere C, et al.. High doses of inhaled corticosteroids during the first trimester of pregnancy and congenital malformations. J Allergy Clin Immunol. 2009;124(6):1229–34 e4. doi:10.1016/j.jaci.2009.09.025.
  • Kallen B, Rydhstroem H, Aberg A. Congenital malformations after the use of inhaled budesonide in early pregnancy. Obstet Gynecol. 1999;93(3):392–5.
  • Cossette B, Beauchesne MF, Forget A, et al. Relative perinatal safety of salmeterol vs formoterol and fluticasone vs. budesonide use during pregnancy. Ann Allergy Asthma Immunol. 2014;112(5):459–64. doi:10.1016/j.anai.2014.02.010.
  • Eltonsy S, Forget A, Beauchesne MF, et al.. Risk of congenital malformations for asthmatic pregnant women using a long-acting beta(2)-agonist and inhaled corticosteroid combination versus higher-dose inhaled corticosteroid monotherapy. J Allergy Clin Immunol. 2015;135(1):123–30. doi:10.1016/j.jaci.2014.07.051.
  • Bakhireva LN, Jones KL, Schatz M, et al.. Safety of leukotriene receptor antagonists in pregnancy. J Allergy Clin Immunol. 2007;119(3):618–25. doi:10.1016/j.jaci.2006.12.618.
  • Sarkar M, Koren G, Kalra S, et al. Montelukast use during pregnancy: a multicentre, prospective, comparative study of infant outcomes. Eur J Clin Pharmacol. 2009;65(12):1259–64. doi:10.1007/s00228-009-0713-9.
  • Gluck JC, Gluck PA. Asthma controller therapy during pregnancy. Am J Obstet Gynecol. 2005;192(2):369–80. doi:10.1016/j.ajog.2004.07.056.
  • Stenius-Aarniala B, Riikonen S, Teramo K. Slow-release theophylline in pregnant asthmatics. Chest. 1995;107(3):642–7. doi:10.1378/chest.107.3.642.
  • Neff RK, Leviton A. Maternal theophylline consumption and the risk of stillbirth. Chest. 1990;97(5):1266–7. doi:10.1378/chest.97.5.1266.
  • Labovitz E, Spector S. Placental theophylline transfer in pregnant asthmatics. JAMA. 1982;247(6):786–8. doi:10.1001/jama.1982.03320310034024.
  • Dombrowski MP, Schatz M, Wise R, et al. Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy. Am J Obstet Gynecol. 2004;190(3):737–44. doi:10.1016/j.ajog.2003.09.071.
  • Bain E, Pierides KL, Clifton VL, et al. Interventions for managing asthma in pregnancy. Cochrane Database Syst Rev. 2014;10:CD010660.
  • Schatz M. The efficacy and safety of asthma medications during pregnancy. Semin Perinatol. 2001;25(3):145–52. doi:10.1053/sper.2001.24569.
  • Schatz M, Zeiger RS, Harden K, et al.. The safety of asthma and allergy medications during pregnancy. J Allergy Clin Immunol. 1997;100(3):301–6. doi:10.1016/S0091-6749(97)70241-0.
  • Wilton LV, Pearce GL, Martin RM, et al.. The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. Br J Obstet Gynaecol. 1998;105(8):882–9. doi:10.1111/j.1471-0528.1998.tb10234.x.
  • Schatz M, Hoffman, CP, Zeiger, RS, et al. Asthma and allergic diseases during pregnancy. In: Adkinson N, Yunginger, JW, Busse, WW, Bochner BS, Holgate ST, Simons FER, eds. Middleton's Allergy: Principles and Practice. 2. 6th ed. Mosby, St. Louis, MO: Elsevier; 2003.
  • Stenius-Aarniala B, Piirila P, Teramo K. Asthma and pregnancy: a prospective study of 198 pregnancies. Thorax. 1988;43(1):12–8. doi:10.1136/thx.43.1.12.
  • Park-Wyllie L, Mazzotta P, Pastuszak A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000;62(6):385–92. doi:10.1002/1096-9926(200012)62:6%3c385::AID-TERA5%3e3.0.CO;2-Z.
  • Gur C, Diav-Citrin O, Shechtman S, et al.. Pregnancy outcome after first trimester exposure to corticosteroids: a prospective controlled study. Reprod Toxicol. 2004;18(1):93–101. doi:10.1016/j.reprotox.2003.10.007.
  • Perlow JH, Montgomery D, Morgan MA, et al.. Severity of asthma and perinatal outcome. Am J Obstet Gynecol. 1992;167(4Pt 1):963–7. doi:10.1016/S0002-9378(12)80020-2.
  • Schatz M, Patterson R, Zeitz S, et al.. Corticosteroid therapy for the pregnant asthmatic patient. JAMA. 1975;233(7):804–7. doi:10.1001/jama.1975.03260070062025.
  • Fitzsimons R, Greenberger PA, Patterson R. Outcome of pregnancy in women requiring corticosteroids for severe asthma. J Allergy Clin Immunol. 1986;78(2):349–53. doi:10.1016/S0091-6749(86)80088-4.
  • Namazy JA, Murphy VE, Powell H, et al.. Effects of asthma severity, exacerbations and oral corticosteroids on perinatal outcomes. Eur Respir J. 2013;41(5):1082–90. doi:10.1183/09031936.00195111.
  • Dombrowski MP, Schatz M. ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists number 90, February 2008: Asthma in pregnancy. Obstet Gynecol. 2008;111(2Pt 1):457–64.
  • Namazy J, Cabana MD, Scheuerle AE, et al. The Xolair Pregnancy Registry (EXPECT): the safety of omalizumab use during pregnancy. J Allergy Clin Immunol. 2015;135(2):407–12. doi:10.1016/j.jaci.2014.08.025.
  • Schatz M, Zeiger RS, Hoffman CP. Intrauterine growth is related to gestational pulmonary function in pregnant asthmatic women. Kaiser-Permanente Asthma and Pregnancy Study Group. Chest. 1990;98(2):389–92.
  • Schatz M, Dombrowski MP, Wise R, et al. Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol. 2006;194(1):120–6. doi:10.1016/j.ajog.2005.06.028.
  • Coates AL, Graham BL, McFadden RG, et al. Spirometry in primary care. Can Respir J. 2013;20(1):13–21. doi:10.1155/2013/615281.
  • Powell H, Murphy V, Taylor D, et al. Management of asthma in pregnancy guided by measurement of fraction of exhaled nitric oxide: a double-blind, randomised controlled trial. Lancet. 2011;378(9795):983–90. doi:10.1016/S0140-6736(11)60971-9.
  • Grzeskowiak LE, Smith B, Roy A, et al. Impact of a history of maternal depression and anxiety on asthma control during pregnancy. J Asthma. 2017:54(7):706–13. doi:10.1080/02770903.2016.1258080.
  • Lim AS, Stewart K, Abramson MJ, et al. Asthma during pregnancy: the experiences, concerns and views of pregnant women with asthma. J Asthma. 2012;49(5):474–9. doi:10.3109/02770903.2012.678024.
  • Lim AS, Stewart K, Abramson MJ, et al.. Management of asthma in pregnant women by general practitioners: a cross sectional survey. BMC Fam Pract. 2011;12:121. doi:10.1186/1471-2296-12-121.
  • Murphy VE, Powell H, Wark PA, et al.. A prospective study of respiratory viral infection in pregnant women with and without asthma. Chest. 2013;144(2):420–7. doi:10.1378/chest.12-1956.
  • Minerbi-Codish I, Fraser D, Avnun L, et al.. Influence of asthma in pregnancy on labor and the newborn. Respiration. 1998;65(2):130–5. doi:10.1159/000029244.
  • Hartert TV, Neuzil KM, Shintani AK, et al. Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. Am J Obstet Gynecol. 2003;189(6):1705–12. doi:10.1016/S0002-9378(03)00857-3.
  • Murphy VE, Schatz M. Asthma in pregnancy: a hit for two. Eur Respir Rev. 2014;23(131):64–8. doi:10.1183/09059180.00008313.
  • Ward KA, Spokes PJ, McAnulty JM. Case-control study of risk factors for hospitalization caused by pandemic (H1N1) 2009. Emerg Infect Dis. 2011;17(8):1409–16.
  • Murphy VE, Clifton VL, Gibson PG. The effect of cigarette smoking on asthma control during exacerbations in pregnant women. Thorax. 2010;65(8):739–44. doi:10.1136/thx.2009.124941.
  • Newman RB, Momirova V, Dombrowski MP, et al. The effect of active and passive household cigarette smoke exposure on pregnant women with asthma. Chest. 2010;137(3):601–8. doi:10.1378/chest.09-0942.
  • Gardner A, Kaplan B, Brown W, et al. National standards for asthma self-management education. Ann Allergy Asthma Immunol. 2015;114(3):178–86 e1. doi:10.1016/j.anai.2014.12.014.
  • Jones MA. Asthma self-management patient education. Respir Care. 2008;53(6):778–84; discussion 84–6.
  • Gibson PG, Coughlan J, Abramson M. Self-management education for adults with asthma improves health outcomes. West J Med. 1999;170(5):266.
  • Murphy VE, Gibson PG, Talbot PI, et al.. Asthma self-management skills and the use of asthma education during pregnancy. Eur Respir J. 2005;26(3):435–41. doi:10.1183/09031936.05.00135604.
  • Chamberlain C, Williamson GR, Knight B, et al.. Investigating women's experiences of asthma care in pregnancy: a qualitative study. Open Nurs J. 2014;8:56–63. doi:10.2174/1874434601408010056.
  • Powell H, McCaffery K, Murphy VE, et al. Psychosocial outcomes are related to asthma control and quality of life in pregnant women with asthma. J Asthma. 2011;48(10):1032–40. doi:10.3109/02770903.2011.631239.
  • Lim AS, Stewart K, Abramson MJ, et al.. Multidisciplinary Approach to Management of Maternal Asthma (MAMMA): a randomized controlled trial. Chest. 2014;145(5):1046–54. doi:10.1378/chest.13-2276.
  • Bisgaard H, Stokholm J, Chawes BL, et al. Fish oil-derived fatty acids in pregnancy and wheeze and asthma in offspring. N Engl J Med. 2016;375(26):2530–9. doi:10.1056/NEJMoa1503734.
  • Hasegawa K, Cydulka RK, Sullivan AF, et al. Improved management of acute asthma among pregnant women presenting to the ED. Chest. 2015;147(2):406–14. doi:10.1378/chest.14-1874.
  • Nelson-Piercy C. Asthma in pregnancy. Thorax. 2001;56(4):325–8. doi:10.1136/thorax.56.4.325.
  • Schatz M, Weinberger SE. Management of asthma during pregnancy. In: Hollingsworth H, Bochner B, Lockwood C, eds. UpToDate. 2015. https://www.uptodate.com/contents/management-of-asthma-during-pregnancy
  • Cossette B, Neauchesne M-F, Forget A et al. Systemic corticosteroids for treatment of asthma exacerbations during and outside of pregnancy. Resp Med. 2014;108:1260–1267 doi:10.1016/j.rmed.2014.07.001.
  • Mendola P, Laughon SK, Mannisto TI, et al. Obstetric complications among US women with asthma. Am J Obstet Gynecol. 2013;208(2):127e1–8. doi:10.1016/j.ajog.2012.11.007.
  • Kallen B, Rydhstroem H, Aberg A. Asthma during pregnancy—a population based study. Eur J Epidemiol. 2000;16(2):167–71. doi:10.1023/A:1007678404911.

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