American Board of Internal Medicine (ABIM) Certification Practice Exam

Which medication is considered safe for use in treating asthma during pregnancy?

1. Oral corticosteroids

2. Inhaled glucocorticoids

3. Long-acting β2-agonists

4. Systemic glucocorticoids

The correct answer is: Inhaled glucocorticoids

Inhaled glucocorticoids are recognized as the first-line treatment for asthma during pregnancy due to their effectiveness in managing asthma symptoms and their relatively safe profile for both the mother and the developing fetus. They primarily act locally in the lungs with minimal systemic absorption, which significantly reduces the risk of potential adverse effects that might arise from systemic medications. The safety of inhaled glucocorticoids during pregnancy has been supported by various studies indicating that their use does not correlate with an increased risk of teratogenic effects or negative outcomes for the fetus. This makes them a preferred choice to maintain asthma control while minimizing risks during pregnancy. Other medications, while potentially effective in managing asthma, do not have the same level of safety or are typically not the first choice. For instance, oral corticosteroids and systemic glucocorticoids carry a risk of systemic side effects, especially when used at higher doses or for prolonged periods. Long-acting β2-agonists may be used in conjunction with inhaled glucocorticoids but are not recommended to be the sole treatment in pregnant women due to limited safety data. In summary, inhaled glucocorticoids provide a balance of effective asthma control while minimizing risks to both mother and fetus,