Pregnancy and Asthma

Having asthma does not necessarily mean having a complicated pregnancy. With proper management of asthma and appropriate medical care during the pregnancy, most women who have asthma can experience healthy pregnancies.

Asthma is one of the most common diseases that can complicate a pregnancy. In some cases, a diagnosis of asthma is not made until a woman becomes pregnant. How asthma affects a woman during pregnancy varies, including:

• One-third of women experience no change in their symptoms of asthma.

• One-third of pregnant women experience more severe symptoms of asthma.

• One-third of pregnant women experience improved symptoms of asthma.

• Symptoms may become more severe as weight increases with pregnancy.

Treating asthma properly during pregnancy is important. Uncontrolled asthma can lead to decreased oxygen intake for the mother, which, in turn, affects the fetus.

Uncontrolled asthma can lead to any of the complications listed below.

Possible complications for the mother

Asthma, when not controlled, can put undue stress on the mother as well as on the fetus. Lack of oxygen will not only deprive the mother, but also the fetus. Other complications from uncontrolled asthma for the mother include:

• Preeclampsia (also known as toxemia in pregnancy) - a disorder of pregnancy characterized by increased blood pressure, water retention, and protein in the urine.

• Gestational hypertension - high blood pressure during pregnancy.

• Hyperemesis gravidarum - a pregnancy disorder characterized by protracted vomiting, weight loss, and fluid and electrolyte imbalances.

• Vaginal hemorrhage - bleeding through the vagina.

• Induced and/or complicated labor - the onset of labor to deliver the fetus and/or labor that may cause complications for the mother or fetus.

Possible complications for the fetus

Lack of oxygen to the fetus from the mother can lead to many health problems in the fetus, including:

• Perinatal mortality

• Intrauterine growth retardation - poor fetal growth in the womb, causing the fetus to be smaller than normal for its gestational age.

• Preterm birth

• Low birthweight

• Neonatal hypoxia - inadequate oxygen for the cells.

Are asthma medications safe to use during pregnancy?

Most asthma medications are not harmful to the fetus or to the nursing baby. In fact, uncontrolled asthma may actually put the mother and fetus at far greater risk than the medication used to control asthma. Always consult your physician for a diagnosis and to develop a specific asthma treatment plan tailored to your individual symptoms.

How can a pregnant woman reduce the chance of having an asthma attack?

The American Lung Association recommends a pregnant woman take the following steps to reduce the risk of having an asthma attack during her pregnancy:

• Avoid asthma triggers, including tobacco smoke and other irritants.

• Continue asthma medications throughout the pregnancy, labor, and delivery, as advised by your physician.

• Exercise with moderation (use medication properly if you have exercise-induced asthma and consult your physician before beginning an exercise program).

• Make sure to get a flu shot, if you will be in your second or third trimester of pregnancy during the influenza (fall-winter) season.

When should a pregnant woman with asthma seek emergency medical treatment?

Even with a proper asthma management plan in place, a pregnant woman should be aware of certain warning signs that may indicate an asthma attack, such as:

• Current medication does not provide rapid improvement of symptoms.

• Improvement from medications is not sustained as long as previously sustained.

• Breathing becomes more difficult.

• Fetal kick count decreases, which may indicate fetal distress.

Always consult your physician about what asthma attack warning signs to look for and when to seek emergency medical treatment.