What Is Asthma in Pregnancy?

In This Article

Women with asthma who wish to conceive or are already pregnant often worry about how their condition might impact their pregnancy and their baby. About 3% to 8% of pregnant women have to deal with pre-existing asthma. While there is some research that shows that the condition can cause pregnancy complications, expectant mothers can usually properly control asthma symptoms so that it rarely poses a significant risk for baby or mother.

Understanding guidelines for using asthma medications during pregnancy, following doctors' recommendations for managing asthma, and knowing about any potential complications can help you plan a healthy pregnancy.

Thoughtful pregnant woman looking out the window
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Symptoms of Asthma in Pregnancy

During pregnancy, you're likely to have the same asthma symptoms that you've had previously, including the classic symptoms:

However, you may experience these to a greater or lesser extent than you did before conceiving. Approximately 30% of expectant women with asthma have more severe symptoms during pregnancy. Other women feel the same or notice their symptoms become milder.

When asthma does worsen, symptoms become most serious between 29 and 36 weeks of gestation. Symptoms usually become less severe in weeks 36 to 40.

Even among those who experience worse asthma symptoms during pregnancy, there seems to be no risk of a severe asthma attack during delivery. In fact, asthma usually improves during labor and delivery.

Symptoms of Complications

Asthmatics may be at risk for preeclampsia, in which blood pressure spikes and high levels of proteinuria (protein in the urine) occur.

Symptoms of preeclampsia may include:

  • Headache
  • Swelling (edema)
  • Nausea or vomiting
  • Abdominal, shoulder, or lower back pain
  • Vision changes
  • Weight gain
  • Hyperreflexia
  • Anxiety

Diagnosis

Asthma may be newly diagnosed during pregnancy, but in those cases, you most likely had asthma previously, and the condition had gone undiagnosed.

Asthma is not brought on by pregnancy or body changes associated with pregnancy. If you are experiencing new breathing problems during pregnancy and have never had asthma before, discuss your symptoms with your doctor right away to identify the cause.

To determine whether you have asthma, your doctor will:

  1. Exam you for common asthma symptoms: wheezing, cough, chest tightness, shortness of breath.
  2. Measure airflow in your lungs and determine whether any decreased airflow improves spontaneously or with treatment.

Women who are newly diagnosed with asthma during pregnancy are 2.7 times more likely to experience asthma exacerbations, including hospitalization.

Assessing Worsening Asthma Symptoms

If your asthma symptoms seem to be worsening, you should discuss it with your obstetrician, allergist, and your pulmonologist. Pregnancy can affect breathing to some degree, so your doctor will perform spirometry to determine whether symptoms are normal pregnancy-related issues of are worsening asthma. Tests will focus on vital and total lung capacity, which are not usually affected during pregnancy.

During your doctor visits explain all asthma-related symptoms. Wheezing, for instance, is never a pregnancy-related symptom. Don't assume that you may be experiencing this as a result of weight gain or pressure from your baby.

Treatment

The first course of asthma treatment for pregnant women is to avoid triggers that cause your immune system to overreact, which in turn can spark an asthma attack.

The next step is to control your symptoms with medication.

Medication for a Healthy Pregnancy

Some expectant mothers experience worsening asthma symptoms because they stop taking asthma medications out of concerns that drugs may affect their baby. Asthma itself, though, is a greater risk to fetal development than the side effects of the medication you can use to control or prevent an asthma attack.

Asthma flare-ups can result in reduced oxygen and blood flow to your baby, This can result in premature birth; low birth weight; and life-long health issues for your child including poor growth, breathing problems, and cerebral palsy.

Inhaled medications are usually the preferred course of treatment because they target the source of asthma symptoms and little of the medication crosses the placenta.

According to research, certain medications can be used to control asthma with limited risk. These include:

A case against using albuterol or any other rescue medications during pregnancy may be made because relying on these inhalers means your asthma is flaring up at least occasionally. The goal is to prevent you from having any asthma attacks during pregnancy in order to prevent loss of oxygen or blood flow to your baby.

If you're experiencing asthma symptoms more than two days per week or waking up because of asthma symptoms more than two nights per month, your asthma is considered poorly controlled. At that point, there is a risk that your baby's oxygen is being reduced. Talk to your doctors about an appropriate asthma action plan to get things under control.

Inhaled steroids are aimed at lowering the likelihood you will suffer an asthma attack. However, while some corticosteroids pose little risk for the developing baby, other medications cross the placenta in high concentrations. Dexamethasone, betamethasone, and oral prednisone, for instance, are not used during pregnancy because they are associated with higher incidences of birth defects.

Other controller medications that may be considered for asthma treatment during pregnancy are theophylline and cromolyn. However, these medications pose more concerns because of side effects and potential interaction with other drugs.

In general, doctors are not likely to prescribe a new medication for asthma during pregnancy. Rather, your asthma plan will probably include using drugs that you have already used to successfully manage your symptoms pre-pregnancy.

Prognosis

If asthma is left uncontrolled during pregnancy, studies suggest that the risk of losing a baby, delivering a premature baby, or having a baby with low birth weight increases by 15% to 20%.

However, asthmatic mothers-to-be should be able to manage their condition with medication. While these treatments do have some risks, the greater concern of injury or complications related to asthma can be avoided.

A Word From Verywell

As a general guideline, one third of asthmatics mothers-to-be will experience worse symptoms during pregnancy, one third will experience less severe symptoms, and the final one third will show no change in symptoms. You can't be sure where you will fall into this mix, so it's vital that you continue to see your asthma specialist throughout your pregnancy and have your asthma monitored.

The best precaution you can take is to avoid the most common triggers, including cigarette smoke, dust, dander, and dust mites, and track any allergens that seem to cause asthma exacerbation. Keeping your symptoms under control will offer you the best path to delivering a healthy baby.

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Article Sources
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