For most birth defects, the researchers found no statistically significant associations between asthma medication use and the development of birth defects.
They did, however, find a positive association between asthma medication use and certain rare birth defects. The risk of isolated esophageal atresia -- an abnormality of the esophagus -- was more than doubled in women who used bronchodilators. The risk of isolated anorectal atresia -- a malformed anus -- was more than doubled with maternal anti-inflammatory use. And, the risk of omphalocele -- a defect in the abdominal wall -- was more than quadrupled for either type of asthma medication.
But, the authors wrote, the "observed associations may be chance findings or may be the result of maternal asthma severity and related hypoxia rather than the medication use."
They added that it's also important to keep these findings in context. The rate of these birth defects ranged from 1.2 to 4.6 per 10,000 births. So, even a four-fold increase in the risk of having one of these defects results in far less than a 1 percent chance for any individual woman and her child.
"As obstetricians, we need to pay attention to this, but it's really important to oxygenate mom. We really need to make sure that there's oxygen flowing freely between mom and baby," said Dr. Mary Rosser, an obstetrician with Montefiore Medical Center in New York City.
Also, Rosser pointed out that there was a lot that wasn't known about the expectant mothers. The authors weren't able to assess the severity of their asthma. They also didn't know anything about the medication doses.
Asthma expert Dr. Jennifer Appleyard agreed with Rosser and Meirowitz. "They really couldn't tease apart what was the medicine and what was the asthma," she said.
"You need to treat the asthma. There's more risk to uncontrolled asthma than a slight possible
All rights reserved