What to Know About Asthma and Pregnancy

Asthma causes the airways to swell and narrow, making breathing difficult. Asthma is the most common chronic disease that can affect pregnancy outcomes. One study estimates that this condition affects between 4% and 8% of those who are pregnant.

Proper control of asthma symptoms and prevention of asthma attacks are vital. This is especially true during pregnancy and when you're trying to conceive, as well as during the postpartum period.

Asthma and Fertility

One 2018 study found a link between asthma and fertility issues in people with a uterus. This was especially true for those in the study who use intermittent treatment with short-acting beta-agonists (SABAs), or rescue inhalers.

While SABAs are routinely used, long-acting beta-agonists (LABAs) are preventive medications used to stop symptoms before they begin, such as coughing, wheezing, and shortness of breath.

The 2018 study found that people with active asthma who used inhaled corticosteroids (ICS) with or without long-acting beta-agonists did not experience fertility issues. Researchers think these findings suggest that preventive measures, particularly the proper use of medications, may play a role in improving asthma control and, in turn, lowering systemic inflammation, a condition that may cause reduced fertility.

Asthma and Gestation

During pregnancy, it's estimated that one-third of people will experience no change in their symptoms, one-third will see their symptoms worsen, and one-third will see improvement in their asthma.

How your asthma presents in one pregnancy will likely indicate how it will affect later pregnancies. However, it is difficult to truly predict how asthma will impact individual pregnancies.

Risks

When well controlled, asthma does not have negative effects on a pregnant person or their baby. However, uncontrolled asthma can lead to pregnancy complications.

Complications associated with uncontrolled asthma during pregnancy include:

• High blood pressure, which can lead to preeclampsia
• Premature delivery
• Stillbirth
• Low birth weight

Uncontrolled asthma lowers levels of oxygen in your blood. And because your fetus gets oxygen from your blood, your baby's blood may also experience a decrease in oxygen, which may negatively impact fetal growth and survival.

It's important to note that these are correlations, and asthma may not be the sole cause of these complications. However, keeping your asthma under control can reduce the chances of these problems occurring.

Treatment

Thankfully, most risks associated with asthma and pregnancy can be lessened with proper treatment. While taking your medication as directed is an excellent place to start, avoiding your triggers is also important since doing so can reduce your dependency on medication. This is especially true during the first trimester when the baby is beginning to develop.

Most asthma medications are safe during pregnancy. However, you will still want to review your current list of medications with your doctor to determine if any changes need to be made. Talk to your allergist about any concerns or questions you may have.

Taking a multifaceted approach to your asthma treatment during pregnancy is important. In addition to sticking to regularly scheduled appointments with your ob-gyn, seeing your allergist on a routine basis to help control your asthma is vital for a healthy pregnancy when you have asthma.

Important considerations your allergist will keep in mind while creating your treatment plan include:

• Asthma severity: Regardless of pregnancy, asthma will vary in severity based on a variety of factors, including the season and even the time of day. Your treatment plan should be tailored to the severity of your condition at any given time.
• Type of medication: Inhaled corticosteroids are preferred during pregnancy, as well as most medications that have been working for you.
• Triggers: Avoid triggers, such as cigarette smoke, pet dander, pollen, and fragrance, even if you're taking your medications.

Concerning Symptoms

Concerning symptoms will be the usual signs indicating that your asthma is worsening. They may include:

• Chest tightness
• Shortness of breath
• Coughing
• Wheezing

Talk to your doctor if you're experiencing any changes in your condition during pregnancy.

Asthma and Postpartum

No matter whether your symptoms worsen or improve during pregnancy, your asthma should return to its usual state by about three months postpartum.

Impact on Recovery

Asthma has been associated with an increased risk of postpartum depression. One study found that people with asthma were 58% more likely to experience postpartum depression one year after delivery than those without asthma.

It is therefore important to be open and honest about how you are feeling as you start your journey as a new parent. If you do experience postpartum depression, know that it is incredibly common and you are not alone. Reach out to your doctor to discuss options for treatment and closely monitor your symptoms.

Breastfeeding

Some research has shown that breastfeeding lowers the risk that a baby will have recurrent episodes of wheezing during their first two years of life. However, it's not clear whether breastfeeding lowers the risk that the baby will develop asthma later in life.

Parents with asthma can safely breastfeed their baby without worrying that it will increase their child's own risk for developing asthma. Research has shown that inhaled steroids have no impact on the nursing baby. Talk to your obstetrician, allergist, and pediatrician to determine the best route for feeding your child postpartum.

Summary

People with asthma may experience fertility issues when they're trying to get pregnant if their condition is not well managed. Uncontrolled asthma has also been associated with pregnancy complications like high blood pressure or low birth weight. Some people with this condition will have improved or worsened symptoms during pregnancy, but any changes will revert a few weeks after giving birth.

A Word From Verywell

If you have asthma and are pregnant (or are planning to become pregnant), let your doctor and allergist know as soon as possible to come up with the best treatment plan for you to manage your symptoms while pregnant. Talk to your medical team about any concerns or questions you may have about your asthma and how it may affect you or your unborn baby.

In the end, properly managing your asthma before, during, and after your pregnancy is best for both your health and your baby's. Taking your medication as directed, exercising regularly, maintaining a healthy weight, and eating a healthy diet also can help.

Frequently Asked Questions

Can asthma get worse when you’re pregnant?

Yes, asthma can impact pregnancy. Some pregnant people will experience no change in their symptoms, while others will see their symptoms worsen or improve. It varies person by person.

Does asthma cause sore chest muscles when pregnant?

Sore chest muscles only happen if your asthma worsens while you're pregnant.

What can a doctor do if you have asthma when you’re pregnant?

Your doctor will monitor the airways of your lungs while you are pregnant so they can adjust your asthma medicines if needed. You should tell your doctor if your symptoms improve or get worse. By limiting your contact with allergens and other asthma triggers, you may need to take less medicine to control your symptoms.

How do you prevent asthma attacks when you’re pregnant?

You can prevent asthma attacks while pregnant by avoiding known triggers, such as pet dander or smoke, as well as taking your medication as directed.