Asthma and Pregnancy

This article has been reviewed by Thanai Pongdee, MD, FAAAAI

If you’re pregnant or are thinking about becoming pregnant, it’s more important than ever to keep your asthma controlled. Avoiding triggers and taking your asthma medications as prescribed can all help ensure a healthy pregnancy for you and your baby-to-be.

A national expert panel* strongly encourages monthly monitoring of asthma during prenatal visits. This is because the course of asthma improves for about one-third of women and worsens for about one-third of women during pregnancy. A monthly evaluation gives your physician the opportunity to step down treatment (if possible) or increase treatment (if necessary).

Asthma attacks are most common during the later weeks of pregnancy, but are very rare during labor itself.

Asthma symptoms include:
•    Wheezing
•    Coughing
•    Chest tightness
•    Shortness of breath

Managing Your Asthma During Pregnancy
Good asthma control is crucial for a healthy pregnancy. An asthma flare-up causes decreased oxygen levels in the blood. This, in turn, can lead to less oxygen reaching the fetus. Low oxygen can impair healthy fetal growth and development.

To minimize risk, pregnant women should avoid allergens that trigger their symptoms. Also, women who smoke should quit prior to getting pregnant as smoking may trigger asthma and can interfere with fetal development.

If you were receiving allergy shots (immunotherapy) prior to becoming pregnant, you can continue this treatment during pregnancy. Just be sure to let your doctor know that you are pregnant. It is not recommended to start allergy shots during pregnancy.

What About Medications?
Continue to see your allergist / immunologist throughout your pregnancy and don’t stop taking your medications. Many mothers-to-be are concerned about taking medications during pregnancy. Yet the risks posed by uncontrolled asthma are much greater than those from asthma treatments.

Inhaled corticosteroids are often the treatment of choice for persistent asthma. Studies have shown them to be effective and low-risk for pregnant women. The National Asthma Education and Prevention Program (NAEPP) recommends two specific drugs: budesonide (inhaled corticosteroid) and albuterol (short-acting Beta 2-agonist) as having good safety profiles when used during pregnancy.

Oral corticosteroids are not preferred for regular asthma treatment during pregnancy. However they can be used to treat severe asthma attacks.

If you are pregnant and think you may have asthma, it’s important to have your condition diagnosed to reduce the risks to your baby. Studies have linked asthma attacks in early pregnancy to birth defects, so don’t wait to have your condition diagnosed.

If you are interested in helping researchers understand more about the effects of asthma and asthma medications on pregnancy, consider enrolling in the VAMPSS project.

*The NAEPP Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma
 

AAAAI - American Academy of Allergy Asthma & Immunology