Based on current data in human pregnancies,
albuterol is the reliever medication of choice, and
budesonide is the preferred controller treatment.
64,65
However, no increase in adverse pregnancy
outcomes has been reported with beclomethasone
or with fluticasone.
66
In addition, recent cohort
showed no association between any dose of inhaled
corticosteroid (ICS) use and perinatal mortality;
67
thus any ICS that achieved optimal control before
pregnancy should be pursued during gestation.
66
Observational studies of inhaled corticosteroids
and inhaled beta-agonists showed no increase in
perinatal risks or congenital malformations.
68-72
Long-acting inhaled beta-agonists (formoterol
and salmeterol) can be used as add-on therapy if
symptoms persist in spite of the already received
ICS treatment. In a large Canadian cohort of
pregnant women with asthma, no increased
prevalence of low birth weight, preterm birth or
small for gestational age was found for LABA
use and ICS doses