In most ER cases, pregnant women did not get standard care
Nearly every 20 seconds, someone is rushed to an emergency room in this country because of an asthma attack*, but a new study suggests that not everyone is treated the same way when they get there. According to new research out of Ohio State University Medical Center, some pregnant women with asthma may not get the care they need, impacting the health of both mom and baby.
Initial findings from the study, which sought to determine if pregnant women presenting acute asthma symptoms receive the same anti-inflammatory medicines and steroids to treat flare-ups as non-pregnant women, suggest that as many as two-thirds of pregnant women do not receive the same medication, leading to more problems. Asthma affects between four and eight percent of pregnant women. Ohio State asthma expert Jennifer McCallister, MD led the small but revealing study recently published in the American Journal of Respiratory and Critical Care Medicine.
“When pregnant women presented for treatment of their mild or moderate asthma attacks, we found that they were treated differently than non-pregnant women,” says Dr. McCallister. “We also found that those women that were not treated as often with steroids tended to come back to the emergency department more often.”
Researchers analyzed the medical records of 123 pregnant women and 123 non-pregnant women, ranging in age from 16 to 40 years, who were treated for asthma in the emergency department between 1996 and 2009. Only 50.8 percent of pregnant women received steroids compared to 72.4 percent of non-pregnant women who received steroids. Similarly, 69.2 percent of non-pregnant women received a prescription for steroids upon discharge, yet only 41.3 percent of pregnant women were discharged with a steroid prescription.
“Some physicians are reluctant to give pregnant asthmatic patients steroids out of fear of the impact it may have on the unborn child. However, those same women who were not treated appropriately during their first trip were nearly four times as likely to return to the emergency department with persistent asthma symptoms within two weeks,” adds McCallister, who is also a pulmonologist and critical care specialist at the Medical Center.
Even though they’re only initial findings, McCallister believes this may be an issue in hospitals everywhere and
wants to do larger studies to find out.
Moms like Jodi Moore of Lewis Center, Ohio, hope that more research will help better educate all women about the risks of asthma and pregnancy. Although she’s known since she was 12 years old that she had asthma, it wasn’t until she was pregnant with her first child that it really began to take a serious toll on her health.
“I was scared about taking the medications, afraid that was going to hurt the baby, but, as my doctor pointed out to me, if I’m not breathing, the baby’s not breathing, so then that’s a scary thought, too.”
Dr. McCallister and Moore agree that the take-home message for moms is that asthma medications are safe and will benefit both mom and baby.
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*Asthma in Adults Fact Sheet, American Lung Association, retrieved May 2010, from their website:
**Under-utilization Of Steroids In Pregnant Asthmatics Presenting To A Tertiary Emergency Department, American Journal of Respiratory and Critical Care Medicine 181, Abstract 2729, May 2010. Presented at the American Thoracic Society International Convention, New Orleans, LA, May 2010.