The safety of albuterol in pregnancy seems to require more clinical data, but studies suggest it can be appropriate for some women. Research into the safety of this medication conducted by the U.S. Food and Drug Administration shows an increased risk of complications in animal studies, with not enough data available on human populations. In a survey study on Michigan Medicaid patients published in 1999, researchers noted some increased risk of birth defects associated with albuterol in pregnancy. Not enough information was available as of 2011 to draw a firm clinical conclusion, however.
This medication is used as a rescue inhaler by patients with asthma and allergies. It dilates the bronchial passages to make it easier to breathe during an attack. For some patients, rescue inhalers alone may be sufficient to control symptoms. Others may also require a long term control medication to limit the risk of attacks. In pregnancy, it is critical that the mother's asthma and allergies be well controlled, and it may be necessary to make some adjustments to the treatment plan as the pregnancy progresses.
Limited placental transfer appears with the use of albuterol in pregnancy, which keeps fetal exposure low. It also doesn't readily cross in breast milk and can be safely used while breastfeeding. Some birth defects have been linked to the use of albuterol in pregnancy, but the incidence is low, and may be linked to other factors. One issue with research on the safety in medications in pregnancy is the limited opportunities to control for environmental factors. There are also ethical concerns which can make it hard to run large scale studies.
Historically, extremely large oral doses of albuterol were used in the prevention of pre-term labor. Asthma inhalers do not provide enough of the medication to have the same effect. As long as women use the medication as directed, they shouldn't experience delays in labor and delivery in connection with albuterol in pregnancy.
Patients with asthma and allergies may want to discuss their options at the start of the pregnancy. Doctors may recommend cutting out medications that are not strictly necessary, or reducing doses to determine if it's possible to get the same level of control with lower concentrations of the drug. Ultimately, in patients who need albuterol to breathe comfortably, the benefits of the medication may outweigh the potential risks to the pregnancy. If an adverse outcome does occur, patients can report it to a drug database, where it will join other information used to evaluate the safety of medications.