Asthma controller therapy during pregnancy

Am J Obstet Gynecol. 2005 Feb;192(2):369-80. doi: 10.1016/j.ajog.2004.07.056.


Objective: This study was undertaken to educate physicians on the safety of asthma controller use during pregnancy.

Study design: A comprehensive literature search using MEDLINE, the Cochrane Controlled Trials Register and Database of Systematic Reviews, EMBASE, and selected bibliographies identified human gestational studies of asthma controller medications from which maternal and fetal outcomes were obtained. The US Food and Drug Administration (FDA) pregnancy category ratings were identified from product package inserts.

Results: Human gestational studies were identified for the inhaled corticosteroids (ICSs) beclomethasone, budesonide, and triamcinolone and for cromolyn sodium, theophylline, and salmeterol. Human pregnancy data support an FDA Pregnancy Category B rating for budesonide. Pregnancy Category B ratings for cromolyn, nedocromil, montelukast, and zafirlukast are based primarily on safety in animal reproduction studies. ICSs other than budesonide, theophylline, zileuton, and long-acting beta 2 -adrenergic agonists are Pregnancy Category C.

Conclusion: Human pregnancy data for many asthma controllers are lacking; nonetheless, data support a range of choices among medications rated Pregnancy Category B.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Abnormalities, Drug-Induced*
  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects
  • Adrenergic beta-Agonists / adverse effects
  • Asthma / drug therapy*
  • Cromolyn Sodium / adverse effects
  • Female
  • Fetus / drug effects*
  • Humans
  • Leukotriene Antagonists / adverse effects
  • Nedocromil / adverse effects
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Theophylline / adverse effects


  • Adrenal Cortex Hormones
  • Adrenergic beta-Agonists
  • Leukotriene Antagonists
  • Nedocromil
  • Theophylline
  • Cromolyn Sodium