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Vil astmamedisinene skade barnet?

Mange kvinner med astma er bekymret for at medisinene de vanligvis bruker, kan skade barnet under svangerskapet. Den molekylære virkemåten av en del astmamedisiner kan gi grunnlag for at man ikke kan utelukke en innvirkning på svangerskapet. Det er blant annet derfor at forbehold ved bruk i svangerskap er spesifisert på mange pakningsvedlegg. Men det er ikke funnet holdepunkter for at vanlige astmamedisiner (som inhalasjonssteroider, beta-2 agonister og montelukast), tatt i vanlige doseringer, virker skadelig på barnets utvikling! 

Det er derimot ingen tvil om at dårlig behandlet astma kan ha svært skadelige helseeffekter for både gravide og foster. Hyppige anfall og mye astmaplager kan blant annet medføre svangerskapsforgiftning, for tidlig fødsel, lav fødselsvekt og økt dødelighet hos barnet under/etter fødselen.

Den gode nyheten er at ved god astmakontroll er det liten eller ingen risiko for økt forekomst av svangerskapskomplikasjoner hos verken mora eller fosteret. Nedtrapping av vedlikeholdsbehandling bør som regel ikke vurderes før eventuelt etter fødselen.

Gravide bør fortsette med astmamedisinene sine akkurat som før de ble gravid. De kan med fordel snakke med sin lege om behandlingen. Dette gjelder spesielt pasienter som behandles med nyere biologiske legemidler mot alvorlig astma. Selv om det finnes få studier, er det så langt ikke sett økt forekomst av misdannelser hos barn født av mødre som brukte et slikt legemiddel (omalizumab) under svangerskapet. 

Gravide med astma anbefales å vaksinere seg mot influensa før influensasesongen, gjerne allerede i første delen av svangerskapet. 

Dette dokumentet er basert på det profesjonelle dokumentet Astma . Referanselisten for dette dokumentet vises nedenfor

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