Asthma in pregnancy and breastfeeding

This content is from the BTS, NICE and SIGN guideline - Asthma: diagnosis, monitoring and chronic asthma management (SIGN 245), 2024.

For recommendations on intrapartum care, see the NICE guideline on intrapartum care for women with existing medical conditions or obstetric complications and their babies.

 

Pregnancy

 

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1.12.1 People with asthma should have an asthma review during early pregnancy and in the postpartum period. Emphasise the importance and safety of maintaining good control of asthma during pregnancy and of continuing asthma medicines to avoid problems for themselves and their baby.

[BTS/SIGN 2019]

 

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1.12.2 Advise anyone who is pregnant and who smokes about the dangers for themselves and their babies and give appropriate support to stop smoking. See the NICE guideline on tobacco for more information.

[BTS/SIGN 2019]

 

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1.12.3 Advise using the following medicines as normal during pregnancy:

  • short-acting and long-acting beta2 agonists
  • inhaled corticosteroids
  • oral theophyllines.

[BTS/SIGN 2019]

 

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1.12.4 Offer oral corticosteroids during pregnancy if needed to treat exacerbations of asthma. Advise that the benefits of treatment with oral corticosteroids outweigh the risks.

[BTS/SIGN 2019, amended BTS/NICE/SIGN 2024]

 

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1.12.5 If leukotriene receptor antagonists or long-acting muscarinic receptor antagonists are needed to achieve asthma control, they should not be stopped during pregnancy.

[BTS/SIGN 2019, amended BTS/NICE/SIGN 2024]

 

Breastfeeding

 

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1.12.6 Use medicines as normal when breastfeeding in line with recommendations in the BNF.

[BTS/SIGN 2019, amended BTS/NICE/SIGN 2024]