Short-acting β-agonists in asthma may reduce fertility in females

Asthma is a common chronic disease affecting number of young women and is associated with 8–13% of pregnancies. In past studies, maternal asthma has been consistently associated with significant perinatal morbidities and mortality but it's impact on fertility are conflicting.

Researchers conducted a study to examine the impact of asthma and asthma medication use on fecundability and time to pregnancy.

They found that the use of short-acting β-agonists (SABAs) in management of asthma was associated with reduced fertility in women.The findings of the Screening for Pregnancy Endpoints (SCOPE) study were published in the European Respiratory Journal.

The data of the SCOPE study were used to examine the impact of asthma and asthma medication on fertility and time to pregnancy (TTP).In the study, healthy nulliparous women from Auckland, New Zealand; Adelaide, Australia; Cork, Ireland; and Manchester and London, United Kingdom were recruited .

The subjects were then classified as having former asthma or diagnosed asthma with no symptoms or medication use in the previous 12 months or current asthma. The women subjects with current asthma were divided by use of intermittent reliever medications only (ie, SABA), or additional use of reliever medications (ie, inhaled corticosteroids [ICS] with or without long-acting β-agonists [LABA]).

Out of a total of 5,617 women in the study, 19.7% had asthma. Of those women, 11.7% had current asthma, and 8% were former asthmatics. In addition women with either current or former asthma were younger, had a higher BMI, and were more likely to smoke and report Caucasian ethnicity.

The researchers found that women with current asthma managed with SABAs had adjusted Fecundability odds ratios (FORs) that were 15% lower. No difference was seen in patients with former asthma, or in those with current asthma managed with ICS with or without LABAs.

Moreover subfertility rates were also increased in women who used SABAs. Additional sensitivity analyses were conducted that included women who conceived via assisted reproductive technologies, but this did not change any risk estimates.

Researchers concluded that management of asthma with SABAs was associated with reduced fertility, whereas the management of asthma with ICS with or without LABAs was not. These findings support appropriate management of asthma with ICS preventer medications to ensure optimal asthma control. Women with asthma planning a pregnancy should be encouraged to continue taking their preventer medications

For further reference log on to:

European Respiratory Journal 2018 51: 1702035;

DOI: 10.1183/13993003.02035-2017