Is there any difference in inhaled steroids when it comes to using them in pregnant patients?—Absar Quereshi, MD, Columbus, Ohio

Asthma is present in 4%-8% of all pregnancies. Multiple studies clearly support the maternal and fetal benefits of asthma control during pregnancy. There is significant evidence for the safety of inhaled corticosteroids (ICS) and beta agonists during all trimesters of pregnancy. Multiple studies have shown no impairment of fetal intrauterine growth when any ICS is used at clinically appropriate doses. Indeed, maternal and fetal outcomes appear optimized by aggressive control of asthma during pregnancy. Consultation with a pulmonologist, allergist, maternal-fetal medicine specialist, or high-risk obstetrician should be considered for all pregnant asthmatics.—Steven Tharratt, MD, MPVM (133-11)