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Fetal risks similar for LABA/ICS vs. ICS in pregnant women with asthma

The risk for major malformations was similar for pregnant women with asthma treated with long-acting beta2-agonist plus inhaled corticosteroids and those treated with inhaled corticosteroid monotherapy, according to recent study results.

Researchers used the Quebec Asthma and Pregnancy Database to establish a cohort of 1,249 pregnant women with asthma (1,302 pregnancies) who were exposed to inhaled corticosteroids (ICS) during the first trimester and who delivered between January 1990 and March 2009.

Six hundred forty-three women who used long-acting beta2-agonist (LABA) plus low-dose ICS and 305 users of medium-dose ICS composed the moderate asthma subcohort, while 198 users of a LABA plus medium dose ICS combination and 156 users of a high-dose ICS made up the severe asthma subcohort. Major congenital malformation risks at birth or in the first year of life were compared between groups.

Malformations were detected in 7.4% of newborns in the first year of life, with those outcomes observed in 6.9% of the moderate and 7.2% of the severe asthma subcohorts.

No significant differences in increased risk for major malformations were observed in women who used combination therapy vs. monotherapy. When a LABA plus low-dose ICS was used vs. medium-dose ICS, the adjusted OR for malformations was 1.1 (95% CI, 0.6-1.9). Using a LABA plus medium-dose ICS produced an aOR of 1.2 (95% CI, 0.5-2.7) compared with high-dose ICS.

“These reassuring results are consistent with asthma management guidelines and provide scientific evidence to help physicians and mothers make evidence-based treatment decisions during pregnancy,” the researchers concluded. “These results should encourage women to continue to take their asthma medications when required to control their asthma during pregnancy. This will increase the likelihood of healthy pregnancies and newborns.”

Disclosure: See the study for a full list of relevant disclosures.