Safety of leukotriene receptor antagonists in pregnancy


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Safety of leukotriene receptor antagonists in pregnancy is a well-researched topic, it is to be used as a guide or framework for your Academic Research.


ackground: Asthma is a chronic disorder that affects about
8% of pregnant women and may complicate pregnancy.
Adequate asthma therapy in pregnancy is crucial but
challenging because of safety concerns for the fetus.
Objective: To evaluate the safety of gestational asthma therapy
with leukotriene receptor antagonists (LTRAs) for the mother
and fetus/newborn.
Methods: Subjects were participants of the Organization of
Teratology Information Specialists Asthma Medications in
Pregnancy Study. Perinatal outcomes among 96 women who
took LTRAs (montelukast or zafirlukast) were compared with
women who exclusively took short-acting b2-agonists (n 5 122)
and women without asthma (n 5 346).
Results: Use of LTRAs was not associated with an increased
risk of pregnancy loss, gestational diabetes, preeclampsia, low
maternal weight gain, preterm delivery, low Apgar scores, or
reduced measures of birth length and head circumference in
infants (P > .05). Slightly decreased birth weight in infants born
to LTRA users could be attributed to maternal asthma severity/
control. The birth prevalence of major structural defects in the
LTRA group (5.95%) was significantly higher compared with
controls without asthma (P 5 .007), but not different from the
comparison group with asthma (P 5 .524). Furthermore, the
defects observed in the LTRA group did not represent a
consistent pattern.
Conclusions: Use of LTRAs in pregnancy was not associated
with a specific pattern of major structural anomalies in
offspring or a large risk of other adverse perinatal outcomes.
Clinical implications: This study suggests that LTRAs do not
appear to be a major human teratogen; however, results should
be interpreted with caution because of limited sample size.


Asthma is among the most common conditions that
might complicate pregnancy. According to the National
Center for Health Statistics and Behavioral Risk Factor
Surveillance System estimates for 2000 to 2003, the
prevalence of current asthma among pregnant women 18
to 44 years of age is estimated to be 8.4% to 8.8%, whereas
the prevalence among younger pregnant women (ie, 18-24
years) might be as high as 12.2% to 12.3%.1 Between
1988 and 2002, prevalence estimates of ever having a di-
agnosis of asthma among pregnant women more than dou-
bled.1 More than a third of pregnant women with asthma
reported experiencing at least one asthma attack in the pre-
vious year, indicating significant asthma-related morbidity.1
Women with asthma have a higher rate of numerous
perinatal complications compared with their counterparts
who do not have asthma. Severe or poorly controlled
asthma is particularly likely to increase the risk of maternal
and fetal complications.2-6 Thus, adequate treatment of
asthma in pregnancy is of great importance but might be dif-
ficult to accomplish because of safety concerns for the fetus.


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Project Topic and Material


Allergy and Clinical Immunology

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