임신 중 벤토린 사용, Ventolin during pregnancy

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1. 임신 중 천식, Asthma during Pregnancy (1)
https://blog.naver.com/sjloveu2/220998571354

2. 임신 중 천식, Asthma during Pregnancy (2)
https://blog.naver.com/sjloveu2/220998575689

3. 임신 중 천식, Asthma during Pregnancy (3)
https://blog.naver.com/sjloveu2/220998614491


임신 중 천식에서 사용하는 흡입 약물은 다음과 같습니다.

이 중에서 속효성 베타작용제인(SABA) 중에서 제안되는 것은 albuterol(salbutamol)인 벤토린입니다.

벤토린이 pregnancy category C이지만 태아에 미치는 영향이 작은데 반해(very small)
조절되지 않는 산모 천식의 위험이 높기 때문에
1단계 천식이나 천식 급성 발작 시에 rescue drug로 벤토린을 사용해야 합니다.

Short-acting beta-adrenergic agonists — The short-acting, selective beta-2 adrenergic bronchodilators (SABAs) are used to provide quick relief of asthma symptoms and appear to be relatively safe during pregnancy. However, some case-control studies have suggested a slight increase in risk of certain infant abnormalities, as noted by the following reports:

•In a case-control study, a small increased risk of gastroschisis was reported among infants exposed in utero to bronchodilators.

•In a case-control study using European registry data, gastroschisis (odds ratio [OR] 1.89, 95% CI 1.12-3.20) and cleft palate (OR 1.63, 95% CI 1.05-2.52) were associated with a greater likelihood of first trimester beta-agonist exposure.

•An association with cardiac defects was noted in a cohort study that examined the effect of exposure to bronchodilator therapy during pregnancy.

•A case control study reported a 30 percent increased risk (OR 1.3, 95% CI 1.1-1.5) of autism spectrum disorder in children exposed to maternal beta-2 adrenergic receptor agonist drugs during gestation.

One problem with assessing the consequences of bronchodilator use in pregnancy is confounding introduced by indication; SABA use is a marker for poorly-controlled asthma and more frequent exacerbations, which may independently contribute to the development of congenital anomalies. Furthermore, some studies only have access to data about prescriptions filled and not the frequency of actual use [30]. Even if the statistical associations for relative risk are valid, the anomalies mentioned above are infrequent. Therefore, the absolute increase in risk is very small and, as noted earlier, less than the risk of poorly-controlled maternal asthma.

REF. UpToDate 2018.3.20