Uncontrolled asthma is associated with an increased risk of adverse perinatal outcomes. Asthma biologics reduce exacerbation frequency, are steroid sparing, and improve quality of life in people with severe asthma. However, evidence for the use and safety of asthma biologics during pregnancy is scarce, largely because pregnant women were excluded from clinical trials. To help to support clinical teams, we conducted an international modified Delphi study. 141 panellists from 32 countries who were involved in the care of people with severe asthma completed two rounds of online surveys covering key areas surrounding the use of asthma biologics in pregnancy. The results from this international Delphi study emphasise risk versus benefit discussions and shared clinical decision making, with consensus among panellists that asthma biologics can be used during conception and throughout pregnancy, initiated during pregnancy in line with prescribing criteria for non-pregnant people, and initiated or continued during breastfeeding. Collating data through international registries remains essential to inform clinical guidelines.

中文翻译：

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妊娠期哮喘生物制剂使用的国际共识


未控制的哮喘与不良围产期结局的风险增加有关。哮喘生物制剂可降低急性发作频率，减少类固醇，并改善严重哮喘患者的生活质量。然而，关于怀孕期间哮喘生物制剂的使用和安全性的证据很少，这主要是因为孕妇被排除在临床试验之外。为了帮助支持临床团队，我们进行了一项国际改良 Delphi 研究。来自 32 个国家的 141 名参与严重哮喘患者护理的小组成员完成了两轮在线调查，涵盖了围绕妊娠期哮喘生物制剂使用的关键领域。这项国际 Delphi 研究的结果强调风险与收益的讨论和共同的临床决策，小组成员一致认为哮喘生物制剂可以在受孕期间和整个怀孕期间使用，根据非孕妇的处方标准在怀孕期间开始使用，并在母乳喂养期间开始使用或继续使用。通过国际登记处整理数据对于为临床指南提供信息仍然至关重要。