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Asthma and Pregnancy

Can asthma or the medications to treat it harm a pregnant woman or her fetus? This might be just one of the many questions going through your head now that you're pregnant or breastfeeding. Dr. Schatz, an asthma and allergy specialist with the Southern California Permanente Medical Group, explains what doctors know about asthma and pregnancy. He also tells you what researchers are still trying to find out.

 

Asthma refers to inflammation (swelling and tightening) in the airways of the lungs. When an asthma attack occurs, it is more difficult for air to pass through the lungs which leads to trouble breathing, coughing, and wheezing.  Triggers that can cause an asthma attack vary from person to person. Trying to avoid these triggers can reduce the number of asthma attacks.  Common triggers include breathing in cold air, cold viruses, allergies to dust, animals, or pollen, strenuous exercise, chemicals, mold, and cigarette smoke.  Asthma is often treated with a combination of short acting inhalers for immediate symptom relief and daily medicines to reduce inflammation.

 
Asthma is considered a common condition. In the United States, it has been estimated that about 1 in 12 pregnant women are affected with asthma (Kwon et al. 2006). Since most people with asthma require medicine to control symptoms, and controlled asthma is very important during pregnancy, a medicine discussion with your doctors is especially important for women with asthma who are planning a pregnancy or have learned they are pregnant.  In general, medicine management during pregnancy should continue to include the medicines that best control the individual’s asthma symptoms.
 
Doctors are not able to predict for any one woman whether her symptoms will improve, stay the same, or worsen during pregnancy.  For about one third of women, symptoms will improve during pregnancy, another one third will have no change in asthma symptoms, and a final one third of women will have worsening of symptoms (Murphy et al. 2005).  The more severe the asthma, it appears the more likely asthma symptoms will get worse during pregnancy (Murphy et al. 2005). Again it is important to actively treat asthma not only before but  during pregnancy.

It is increasingly being recognized that asthma, and in particular, poorly controlled asthma, is associated with somewhat higher rates of pregnancy complications, including placental problems, high blood pressure conditions, premature delivery, higher rates of C-section, and low birth weight (Kallen 2007).  Therefore it is generally considered safer for maternal and fetal health to actively treat asthma during pregnancy. The majority of asthma medicines have been shown to have no harmful effects on the developing pregnancy or very limited effects.  An open discussion with your treating doctors about your preferred pregnancy treatments for asthma is important for good pregnancy outcomes.

 

References: 

Kallen B (2007) The safety of asthma medications during pregnancy. Expert Opin Drug Saf 6(1):15-26.

Kwon HL, Triche EW, Belanger K, Bracken NB (2006) The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am 26(1):29-62.

Murphy VE, Gibson PG, Smith R, CliftonVL (2005) Asthma during pregnancy:mechanisms and treatment implications. Eur Respir  25:731-750.

Asthma Fact Sheet

Asthma and Medications in Pregnancy Surveillance System

Academy of Allergy Asthma & Immunology


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