By Mara Gaudette, MS, CGC, Teratogen Information Specialist, MotherToBaby
My friend Jocelyn, recently (and unexpectedly!) pregnant called in a bit of a panic. Her cardiologist was changing her high blood pressure medication now that she was pregnant. Jocelyn was still waiting for her asthma doctor to call her, but she felt that her asthma treatment plan was another of the many changes she needed to make to cope with the pregnancy. “Does anything stay the same?” asked.
Jocelyn was relieved to learn that at least in the case of asthma, the answer is, often, YES! The general thinking is that the medicines that work to treat asthma in a non-pregnant person are the same ones that should be continued during pregnancy. This is because the main concern is the asthma itself and making sure the growing baby has a good oxygen supply. Improving asthma control is thought to be best for both mom and baby.
Jocelyn has been on an inhaled corticosteroid for the past five years – ever since she has needed to use her rapid-acting rescue inhaler almost every day. Fortunately, for Jocelyn, if she needs daily preventative treatment, an inhaled corticosteroid like the Pulmicort® she was already taking is the treatment of choice. Why; Well, for one thing, it often works well to stop the symptoms. Second, because it is inhaled, less of the drug should be able to reach a pregnancy compared to most oral drugs. For the same reasons, albuterol for the relief of immediate asthma symptoms is also considered a preferred treatment during pregnancy. However, if Jackie had been using other types of inhalers when she recognized her pregnancy, and they were working well for her, they probably wouldn’t need to be changed either.
Poorly controlled maternal asthma is associated with higher rates of pregnancy complications, such as reduced baby growth and preterm birth (birth before 37 weeks). Therefore, it is important that asthma management during pregnancy continues to include the medications that best control a person’s asthma symptoms. “Okay,” Jocelyn said. “I will continue with my inhalers and ask the doctor’s office again to contact me to confirm.”
Fortunately, the next call I got from Jocelyn wasn’t as panicked. “Sounds like my doctor wants me to continue my asthma inhalers.” With a calmer tone to her voice than our first conversation, she added, “although I would never be a guinea pig, it would be nice to be able to help other pregnant people with asthma so they don’t have to go through the scare once it’s passed.” I told her that we can never have too much information when it comes to asthma and treatments during pregnancy and informed her that at MotherToBaby we continue to enroll pregnant women with asthma, pregnant women on asthma medication, and even pregnant women without asthma. There is no cost and you are not required to take any medication… so no need to apply for guinea pigs! Just call 877-311-8972 or volunteer for a study through our website.
“Oh, what about my allergy medicine?” Jocelyn remembered to ask. “When I don’t take Zyrtec®, my asthma flares up and my allergies are crazy this spring.” I informed her that antihistamines in general have a relatively reassuring pregnancy profile, but it’s always good to check on that particular drug. Pregnancy studies with cetirizine, the drug found in Zyrtec®, did not find an increase in birth defects. You can check the product label to make sure cetirizine is the only drug in your product, as brand-name products can make different formulations. As with any medication in pregnancy, check with your healthcare provider and follow their dosage recommendations.
More detailed information on medication can be found in the following newsletters:
Bottom line, breathe in, breathe out and enjoy your pregnancy to the fullest!
Mara Gaudette is a genetic counselor and received her master’s degree from Northwestern University. He was drawn to the gratification of providing immediate
reassuring worried women, he began educating the public about teratogens MotherToBaby’s Illinois affiliate more than a decade ago. Today, she advises MotherToBaby California via phone and live chat.
MotherToBaby is a service of the International Organization for Special Teratology Information (OTIS), a recommended resource by many agencies, including the Centers for Disease Control and Prevention (CDC). If you have questions about medications, alcohol, diseases, vaccines or other exposures during pregnancy or breastfeeding, call MotherToBaby TOLL FREE at 866-626-6847 or visit MotherToBaby.org to browse a library of newsletters and find your nearest partner.
