Asthma and Pregnancy: Get the Facts

Although asthma is a chronic respiratory condition, there is no reason why a woman with asthma cannot have a successful pregnancy. The key is to know the facts and to keep your asthma under optimal control.

It's true that severe asthma can sometimes place a pregnant woman at greater risk for certain complications. And some pregnant women with asthma do report that their asthma symptoms got worse during pregnancy. However, with the right treatment and care throughout your pregnancy, you can have a positive outcome for you and your baby.

How Pregnancy Affects Asthma Severity & Control

It's interesting that there is a wide diversity of effects by pregnancy on the severity of asthma.

  • One-third of women will see asthma symptoms get worse during pregnancy.
  • One-third of women will see asthma symptoms get better during pregnancy.
  • One-third of women will not see any changes in the severity of their asthma symptoms during pregnancy.

As you can surmise, it's quite difficult to predict the effect of pregnancy on any one woman's asthma. There are a few things we know for sure, though:

  • Women whose symptoms get worse usually see these changes between weeks 29 and 36.
  • Women whose symptoms get better usually notice these improvements throughout pregnancy.
  • Asthma tends to be less severe during the final month of pregnancy.
  • Asthma rarely gets worse during labor and delivery.
  • Most women whose symptoms changed during pregnancy will return to their pre-pregnancy asthma condition within 3 months after delivery.
  • Most women will have the same experience with each succeeding pregnancy. So, if your symptoms get worse the first time around, they probably will do so each time after that too.

How Asthma Affects Pregnancy

It's important to note that the vast majority of pregnant women who have asthma do not have complications during pregnancy, labor or delivery. However, there does seem to be a slightly increased risk of complications in pregnant women with asthma.

Experts are not sure why this risk exists, but the following complications tend to be more frequent in women whose asthma is not well-controlled:

  • High blood pressure and pre-eclampsia
  • Premature birth of the baby
  • Cesarean delivery
  • Low birth weight of the baby

When asthma is not well-controlled, the mother has less oxygen in her blood. So that means the fetus also has less oxygen in his/her bloodstream. That may affect fetal growth and development, although studies are not conclusive on this fact. Still, keeping your asthma under control throughout pregnancy should be your goal.

What Can or Should the Pregnant Mother-to-Be Do?

Asthma control is your best bet to positive pregnancy outcomes. So, getting consistent care from both your asthma doctor and your obstetrician throughout pregnancy will help you achieve that goal.

Make sure you follow your asthma treatment plan and that you have an asthma action plan in place. Keep taking your asthma medications, as long as they are approved by your health care team. Remember -- any risk to your fetus from most asthma medications is quite small when compared to the risk from a severe asthma attack.

But some asthma medications are considered safer than others, for example:

  • short-acting inhaled bronchodilators
  • anti-leukotriene agents such as montelukast (Singulair)
  • some inhaled corticosteroids, like budesonide

Other asthma medications, such as long-acting bronchodilators (beta agonists) and theophylline, are not recommended unless other medications do not provide adequate control. In severe cases, oral prednisone may be prescribed for the health of mother and baby.

Also, work to avoid your known asthma triggers. Examples of such allergens are dust mites, pollen, pet dander, cockroaches and molds. Avoiding these things will help prevent asthma attacks and severe symptoms. Although you can use asthma medication during pregnancy, increasing your efforts to avoid triggers will mean you need less of that medicine.

If you are taking allergy shots before getting pregnant, it should be safe to continue them during pregnancy. Speaking of shots, never use pregnancy as an excuse not to get a flu shot. All people with asthma need to get their yearly flu shot!

In Summary

If you have asthma, it should be perfectly safe to get pregnant. Just be sure to get regular care from both your regular doctor and your obstetrician throughout your pregnancy, so that you can keep your asthma under control. Take your medications and avoid your triggers. Stay active, eat right and get plenty of sleep.

After your baby is born, you'll need to continue your asthma medication, even if you are breastfeeding. Babies born to mothers with asthma do have an increased risk of developing asthma themselves. The good news is that asthma is usually easy to treat and control, no matter what age you are.

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