Medicines prescribed for asthma, discontinuation and perinat
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Asthma medication prescription before or during pregnancy was associated with a higher prevalence of premature birth and lower birth weight among infants, particularly if medication was discontinued during pregnancy, researchers reported.

A study was conducted to explore associations between exposures to medicines prescribed for asthma and their discontinuation in pregnancy and preterm birth [less than 37 or less than 32 weeks], SGA [less than 10th and less than 3rd centiles], and breastfeeding at 6–8 weeks.

Odds ratios for adverse pregnancy outcomes were calculated for the exposed versus the unexposed population, adjusted for smoking, parity, age and socio-economic status. The population-based cohort study included 110,727 individuals born from 2000 to 2010 in Wales with data on premature birth, small gestational age and breastfeeding.

The primary outcomes were premature birth (premature, less than 37 completed week's gestation; very premature, less than 32 completed week's gestation), growth centiles for infants below the 10th and third percentiles defined from WHO standards, and breastfeeding routinely recorded by health visitors at birth and 6 to 8 weeks.

Asthma medication prescriptions were associated with premature birth at less than 32 week's gestation (adjusted OR = 1.33), small gestational age less than 10th centile (aOR = 1.1) and no breastfeeding (aOR = 0.93) whether continued or discontinued during pregnancy. Asthma medication prescription discontinuation was associated with birth at less than 37 week's gestation (aOR = 1.22) and less than 32 week's gestation (aOR = 1.53), according to the results.

Researchers observed an association with small gestational age less than the 10th percentile with all asthma medications, except inhaled corticosteroids and short-acting beta agonists prescribed alone.

Reduced risks with inhaled corticosteroids suggest that increased monitoring, targeted support and active asthma management are needed before, during and after pregnancy. Programming primary care electronic records to alert professionals to contact women who leave greater than 4 months between prescriptions for asthma medications might make this feasible.

Conclusively, prescription of asthma medicines before or during pregnancy was associated with higher prevalence of adverse perinatal outcomes, particularly if prescriptions were discontinued during pregnancy.