FCAAIA Notes: Pregnant or not, not too many people want to take medications they don’t need. But you always need to consider the risks of the disease as compared to those of the treatment.
The safety profile of medications for asthma (especially inhaled ones) is extraordinary, recognizing that nothing is 100%. But the risks of poorly controlled asthma in pregnancy are also extraordinary. As a result, our guidelines and tenets of for the care of pregnant women with asthma have not changed much over the last 20+ years. Continue reading “ASTHMA DURING PREGNANCY: EXACERBATIONS, MANAGEMENT, AND HEALTH OUTCOMES FOR MOTHER AND INFANT”
FCAAIA Notes: In pregnancy, about 1/3 of mothers with asthma get worse, 1/3 get better, and 1/3 remain the same. The pattern tends to be the same from one pregnancy to the next. The control often improves in the last trimester. The health of the mother is paramount during pregnancy. Guidelines for the treatment of asthma in pregnancy have been around for a long time and are reviewed and updated regularly.
Poorly controlled asthma is more of a risk to the fetus than the medications used to treat it. Continue reading “ASTHMA DURING PREGNANCY: EXACERBATIONS, MANAGEMENT, AND HEALTH OUTCOMES FOR MOTHER AND INFANT”
FCAAIA Notes: About 4 years ago, I posted an abstract indicating that giving infant’s fish oil did not decrease their incidence of allergic disease (“Fish Oil Does Not Prevent Early Allergies in Infants). In this study, the children of women who took either fish oil or placebo during the second half of pregnancy did not ultimately show any difference in their rates of allergic disease. Children whose mothers took fish oil were less likely to have a positive skin test to dust mites but did not have less allergic disease.
Here’s an important point however: The thymus gland which is essential for the development of white blood cells called T cells and the development of “tolerance” (not having allergy) forms early in gestation and is already formed by 20 weeks. To really answer the question the authors asked, I would like to see this study repeated with fish oil supplements being started as soon as the woman is known to be pregnant. Continue reading “PRENATAL FISH OIL DOES NOT REDUCE IGE-ASSOCIATED ALLERGIES IN CHILDREN”
FCAAIA Notes: The best data on probiotics and allergic disease probably apply to atopic dermatitis and food allergy in infancy. Unfortunately, while there are some studies indicating some benefits, none have been so conclusive that it is a recommendation we routinely make. Some good news is that probiotics and prebiotics are unlikely to be harmful to mother, fetus, or infant (as far as we know!). Furthermore, not all studies use the same probiotics, so we cannot recommend a particular species.
I think the data on probiotic use to prevent allergic disease is nicely summarized by the authors and appears at the end of this article: “If probiotics are used in infants, Continue reading “GUIDELINES DESCRIBE USE OF PROBIOTICS IN PREVENTING ALLERGIC DISEASES”