Systemic corticosteroids for the treatment of asthma exacerbations during and outside of pregnancy in an acute-care setting.
Respir Med. 2014 Jul 11;
Authors: Cossette B, Beauchesne MF, Forget A, Lemière C, Larivée P, Rey E, Couturier M, Rodrigue C, Blais L
BACKGROUND: Asthma exacerbations are common during pregnancy with a prevalence as high as 51.9% among women with severe asthma.
OBJECTIVE: To compare the treatment of asthma exacerbations in an acute-care setting during and outside of pregnancy.
METHODS: We formed a cohort of women who sought medical care for an asthma exacerbation at a teaching hospital during or in the year preceding pregnancy, between 1998 and 2008. An exacerbation was composed of one or more medical encounters in an acute-care setting (hospital-based outpatient clinic, emergency department, or during hospitalization). Data were retrieved from medical charts and health administrative databases. We compared the use of systemic corticosteroids (SCSs) during and outside of pregnancy with a Cox proportional hazards model.
RESULTS: The cohort was formed of 39 women who had 40 exacerbations during and 39 exacerbations outside of pregnancy. Use of SCSs to treat exacerbations was less frequent (adjusted hazard ratio: 0.51; 95% CI: 0.31-0.84) during pregnancy. Moreover, upon the first medical encounter related to the exacerbation, SCSs, when administered, were given less frequently to women when pregnant than when non-pregnant (83% vs. 100%). The SCS prescription was filled at the community pharmacy 65% and 67% of the time when it was prescribed at discharge to women when pregnant than when non-pregnant, respectively.
CONCLUSION: We observed a reduced and delayed use of SCSs for the treatment of asthma exacerbations in women when pregnant than when non-pregnant, with similar numbers of women in both conditions filling their SCSs prescription in pharmacies.
PMID: 25060542 [PubMed - as supplied by publisher]