The Safety of Long-Acting Beta-Agonists in Pregnancy
Bibliographic record
Abstract
Abstract Rationale: Asthma is the most common chronic disease affecting pregnant women, yet data on the safety of some asthma medications are limited. Inhaled corticosteroids (ICS) have been shown to be acceptable for the treatment of asthma in pregnancy, but there are limited data on the safety of long-acting beta agonists (LABA) or combination therapy with ICS-LABA. In the general non-pregnant population with uncontrolled asthma, the addition of a LABA to ICS therapy has been shown to be more effective than increasing the dose of ICS. We sought to determine the risk for birth defects and spontaneous abortion in pregnant LABA users. Methods: Pregnant participants residing in the US or Canada were recruited prior to 20 weeks’ gestation between 2009 and 2014 by MotherToBaby Pregnancy Studies at UC San Diego. Referrals to the study came from healthcare providers and women who were self-referred. The exposed group was comprised of pregnant asthmatic patients treated with LABA. Two comparison groups were recruited including pregnant asthmatic women who had used only SABAs and a non-diseased comparison group of pregnant women who did not have asthma. Data on exposures, major congenital malformations and spontaneous abortion were collected by maternal interviews and medical records abstraction. The relative risk (RR) and 95% Confidence Intervals (CI) for major malformations was calculated using exact methods, and the hazard ratio (HR) and 95% CI for spontaneous abortion was calculated using Cox proportional hazards. Results: 439 subjects with outcomes were enrolled with 100 exposed to LABAs, 103 exposed to SABAs only, and 236 unexposed comparison women. Twenty participants (4.6%) were lost to follow-up. Characteristics are shown in the Table. Infants of women exposed to LABA during pregnancy were not significantly more likely to have major birth defects compared to SABA alone (RR 1.20, 95% CI [0.42, 3.39]) or infants of non-asthmatic women (RR 1.27, 95% CI 0.45, 3.12). There was no increased risk of spontaneous abortion in those exposed to LABA versus SABA (HR 0.33, 95% CI [0.08, 1.27]) or LABA versus unexposed non-asthmatic women (HR 0.62, 95% CI 0.17, 2.31). Conclusion: There was no evidence of a significant increased risk of major birth defects or spontaneous abortion in pregnant women exposed to LABAs. Because ICS have also been shown to be safe in pregnancy, these data provide support for the use of ICS-LABA therapy in pregnant patients in accordance with the latest guidelines for asthma management in the general population.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".