pulmicort and Fetal-Death

Inhaled corticosteroids are recommended as first-line therapy for pregnant women with moderate to severe asthma, although the effects on pregnancy outcome are uncertain. A low compliance with the recommendations might lead to inadequate control of asthma, which has been associated with adverse outcomes both for the mother and the infant.. To investigate whether the reported use of inhaled budesonide (Pulmicort) during pregnancy influences birth outcome.. Data were derived from the Swedish Medical Birth Register, which includes 99% of births in Sweden. During 1995 to 1998, 293,948 newborn infants were identified. Pregnancy outcomes were compared for mothers in Sweden reporting asthma medication usage with those reporting no asthma medication usage.. The 2,968 mothers who reported use of inhaled budesonide during early pregnancy gave birth to infants of normal gestational age, birth weight, and length, with no increased rate of stillbirths or multiple births. The rate of caesarean births was higher among mothers who used asthma medication during their pregnancy than among the control group.. The use of inhaled budesonide in Sweden is not linked with any clinically relevant effects associated with pregnancy outcome.

Topics: Administration, Inhalation; Asthma; Birth Weight; Body Height; Budesonide; Cesarean Section; Female; Fetal Death; Fetus; Gestational Age; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Pregnancy Outcome

The purpose of this study was to compare efficacy on fetal lung maturation of intra-amniotic betamethasone or budesonide with the efficacy of maternal intramuscular betamethasone.. Pregnant ewes received intra-amniotic betamethasone (0.5 mg/kg or 2 mg/kg fetal weight), intra-amniotic budesonide (0.5 mg/kg or 2 mg/kg), maternal intramuscular betamethasone (0.5 mg/kg maternal weight), intra-amniotic saline solution, or maternal saline solution. Lambs were delivered 2 or 7 days later, at 124 days of gestation for measurement of respiratory system compliance, ventilatory efficiency index, and surfactant levels.. Lung function increased 2 days after maternal betamethasone, intra-amniotic betamethasone (2 mg/kg), and intra-amniotic budesonide (2 mg/kg) administration and 7 days after maternal betamethasone or intra-amniotic budesonide (2.0 mg/kg) administration. Lung function was not improved 7 days after intra-amniotic betamethasone (2.0 mg/kg) administration or 2 days after intra-amniotic betamethasone (0.5 mg/kg) or intra-amniotic budesonide (0.5 mg/kg) administration. Intra-amniotic corticosteroid administration increased fetal death and respiratory morbidity.. Intra-amniotic corticosteroid administration improved preterm lung function, but the associated morbidity and mortality rates suggest that they are not suitable for clinical use.

Topics: Amnion; Animals; Animals, Newborn; Betamethasone; Budesonide; Female; Fetal Death; Fetal Organ Maturity; Fetus; Glucocorticoids; Incidence; Injections, Intramuscular; Lung; Lung Injury; Mothers; Pregnancy; Pulmonary Emphysema; Pulmonary Surfactants; Respiratory Tract Diseases; Rupture; Sheep; Treatment Outcome