Uncontrolled asthma during pregnancy increases risk of complications

MILWAUKEE-Asthma affects up to 8% of pregnant women and can get worse during pregnancy in approximately 30% of women, making it a very serious medical problem to complicate pregnancy, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

Due to a decreased amount of oxygen in the asthmatic mother's blood, there is a direct relationship between low birth weight and uncontrolled asthma. Since a fetus requires a constant supply of oxygen for normal growth and development, decreased oxygen can lead to impaired fetal growth and survival.

Studies show, however, that maternal asthma that is well managed during pregnancy does not increase the risk of maternal or infant complications.

A 2003 study by the Maternal Fetal Medicine Units Network of the National Institute of Child Health and Human Development (NICHD) found that asthma severity increased in 30% of women, and decreased in 23% of women from the beginning to the end of pregnancy.

"Because of these changes in severity, pregnant women should stay in close contact with their allergist/immunologist so he or she can monitor her condition, and alter her medications or dosages if necessary," said Michael Schatz, MD, MS, FAAAAI, and a past president of the AAAAI.

Women with other conditions such as allergic rhinitis, sinusitis or gastroesophageal reflux disease (GERD) should have those conditions treated as well. These conditions can often become more troublesome during pregnancy and can aggravate asthma, and an allergist/immunologist can review how to properly manage these conditions.

Pregnant women, like others with asthma, should avoid asthma triggers, including specific allergens such as house dust mites, animal dander and irritants such as cigarette smoke.

Asthma management
Pregnant women with asthma should see an allergist/immunologist as soon as possible to discuss the best way to manage their asthma and what medications to take. An allergist/immunologist will prescribe effective asthma and allergy medications that are appropriate to use during pregnancy, and will continue to work throughout the pregnancy to ensure the treatments are effective, without side effects.

Studies and observations of thousands of pregnant women with asthma have demonstrated that most inhaled asthma medications are appropriate for patients to use while pregnant. The risks of uncontrolled asthma appear to be greater than the risks of necessary asthma medications. However, oral medications (pills) should be avoided unless necessary to control symptoms.

It is best if women see their allergist/immunologist regularly during pregnancy so that any worsening of asthma can be countered by appropriate changes in the management program. In addition, the AAAAI's How the Allergist/Immunologist Can Help: Consultation and Referral Guidelines Citing the Evidence provide information to assist patients and health care professionals in determining when a patient may need consultation or ongoing specialty care by the allergist/immunologist. Patients should see an allergist/immunologist if they:

• Have moderate-severe or uncontrolled asthma.
• Have a history of severe asthma flare-ups.
• Have a family history of allergies and are interested in identifying prevention strategies for their infant

To find an allergist/immunologist in your area or to learn more about allergies and asthma, call the AAAAI's Physician Referral and Information Line at (800) 822-2762 or visit the AAAAI Web site at www.aaaai.org.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has more than 6,500 members in the United States, Canada and 60 other countries. The AAAAI serves as an advocate to the public by providing educational information and a physician referral directory through its Web site at www.aaaai.org.

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