Key Findings: Maternal Asthma Medication Use and the Risk of Selected Birth Defects

Recently, researchers used data from the National Birth Defects Prevention Study (NBDPS) to examine maternal asthma medication use during pregnancy and the risk of certain birth defects. The results were published in Pediatrics. You can read the abstract here. The findings from this article are summarized in the following text.

Asthma—a disease that affects the lungs:

Asthma is a common disease during pregnancy, affecting about 4%–12% of pregnant women.^1,2 About 3% of pregnant women use asthma medications, including bronchodilators or anti-inflammatory drugs.³ Currently, guidelines recommend that women with asthma continue to use medication to control their condition during pregnancy.⁴ However, the safety data on using asthma medications during pregnancy are limited.

Main findings from this study:

• Data from the study showed that using asthma medication during pregnancy
  • Did not increase the risk for most of the birth defects studied.
  • Might increase the risk for some birth defects, such as esophageal atresia (birth defect of the esophagus or food tube), anorectal atresia (birth defect of the anus), and omphalocele (birth defect of the abdominal wall).
• The most commonly reported asthma medications used during pregnancy were
  • Albuterol (2%–3% of women)
  • Fluticasone (About 1% of women)
• It was difficult to determine if asthma or other health problems related to having asthma increased the risk for these birth defects, or if the increased risk was from the medication use during pregnancy.

Medication during pregnancy: CDC activities

About 1 in every 33 babies is born with a birth defect.⁵ Birth defects are one of the leading causes of infant deaths, accounting for more than 20% of all infant deaths.⁶ CDC is committed to working with its partners and the public to build a comprehensive approach to understanding and communicating the risks of birth defects that potentially are associated with the use of medications during pregnancy.

• Research: CDC funds a large study of birth defects called the National Birth Defects Prevention Study. This study is working to identify risk factors for birth defects and to answer questions about some medications taken during pregnancy.
• Technical expertise: CDC works with staff from the U.S. Food and Drug Administration and other professionals to help conduct studies on the effects of medication use during pregnancy and ways to prevent harmful effects.

More Information

To learn more about medication use during pregnancy, please visit https://www.cdc.gov/pregnancy/meds/index.html.
For more information about birth defects, please visit www.cdc.gov/birthdefects.

Reference

1. Kwon HL, Belanger K, Bracken MB. Asthma prevalence among pregnant and childbearing aged women in the United States: Estimates from National Health Surveys. Ann Epidemiol. 2003; 13:317-324.
2. NAEPP Expert Panel Report. Managing asthma during pregnancy: recommendations for pharmacological treatment – update 2004. J Allergy Clin Immunol. 2005;115:34-36.
3. Kallen B, Olausson PO. Use of anti-asthmatic drugs during pregnancy. 3. Congenital malformations in the infants. Euro J Clin Pharmacol. 2007;63:383-388.
4. Osur SL. The management of asthma and rhinitis during pregnancy. J Women’s Health. 2005; 14:263-276.
5. Centers for Disease Control and Prevention. Update on Overall Prevalence of Major Birth Defects–Atlanta, Georgia, 1978-2005. MMWR Morb Mortal Wkly Rep. 2008;57(1):1-5.
6. Heron MP, Hoyert DL, Murphy SL, Xu JQ, Kochanek KD, Tejada-Vera B. Deaths: Final data for 2006. National vital statistics reports; vol 57 no 14. Hyattsville, MD: National Center for Health Statistics. 2009.

Reference for Key Findings Feature:

• Lin S, Munsie JP, Herdt-Losavio ML, Druschel C, Campbell K, Browne M, Romitti P, Olney R, Bell E. Maternal Asthma Medication Use and the Risk of Selected Birth Defects. Pediatr. 2011 [Epub ahead of print]