How does asthma affect pregnancy?
Asthma is a long-term lung condition that can be well-managed with the right treatment.
The risk of pregnancy complications is low when asthma is well-controlled, but otherwise, asthma can increase the risk of certain problems.
This article explores the effects, complications, and safe treatments of asthma during pregnancy.
How does asthma affect pregnancy?
A person should try to control their asthma during pregnancy to reduce the risk of preeclampsia.
Asthma is the most common chronic disease that affects pregnant women. However, well-managed asthma is not a concern during pregnancy.
If a woman controls asthma symptoms with effective treatment, they are unlikely to cause any pregnancy complications.
It is important to note that asthma symptoms flare in up to 45 percent of pregnant women with the condition. If asthma is severe or not treated effectively, symptoms during pregnancy can increase the risk of complications.
According to a 2013 medical review, women with mild asthma are unlikely to experience more severe symptoms during pregnancy. Women with moderate to severe asthma may find that pregnancy makes their symptoms worse.
If symptoms do worsen, this is most likely to happen late in the second trimester. Exacerbations of symptoms occur infrequently during late pregnancy and labor.
Stopping or reducing the intake of medication during pregnancy can make symptoms worse for women with any type of asthma.
If a person's asthma is not well-controlled during pregnancy, they have an increased risk of preeclampsia.
Preeclampsia can harm the woman and the fetus. Estimated to occur in at least 5–8 percent of all pregnancies, the condition can progress rapidly without treatment.
Symptoms of preeclampsia include:
- high blood pressure
- protein in the urine
- sudden weight gain
- abdominal pain
- nausea and vomiting
- changes in vision
Early diagnosis and treatment is important. Without treatment, preeclampsia can be life-threatening to the woman and the unborn baby. However, with the correct treatment, most women make a full recovery.
Other potential complications of poorly controlled asthma during pregnancy include:
- restricted growth
- low birth weight
- premature birth
A woman may also need to have a cesarean delivery.
The complications result from the baby not getting enough oxygen in the womb. This can occur when asthma symptoms regularly impede a woman's breathing.
Women who experience asthma flare-ups during pregnancy are more likely to have babies with low birthweights than women whose asthma symptoms remain stable. Premature birth and low birth weight may lead to other childhood health problems.
Safe asthma treatments during pregnancy
It is important to continue with asthma treatment during pregnancy.
Authors of a 2013 review note that standard asthma therapies are generally considered low-risk in pregnancy.
That said, doctors consider some asthma medications to be safer than others. Preferred treatments during pregnancy include:
- inhaled corticosteroids
- short-acting beta agonist, or SABA, inhalers
Doctors may avoid prescribing certain asthma medications to pregnant women unless they are necessary to control symptoms. These include:
- sodium cromoglicate
- leukotriene receptor antagonists, or LRTAs
Many doctors agree that the safest option is for pregnant women with asthma to take medications and avoid flare-ups, which can lead to complications.
Some doctors use allergy shots to reduce allergen-induced asthma flare-ups. If a woman already gets these regularly, it is safe to continue doing so while pregnant. However, it is not a good idea to start these during pregnancy, as there is a risk of anaphylactic shock.
Anyone concerned about the safety of treating asthma during pregnancy should speak with a doctor.
A person should see the doctor regularly when pregnant to prevent asthma complications.
The aim of asthma treatment during pregnancy is to avoid flare-ups. This helps to ensure that the fetus gets a steady supply of oxygen, reducing the likelihood of complications.
A doctor will step up treatment according to the severity of a woman's symptoms, then reduce the medications once the symptoms are under control.
The doctor will monitor the woman's lungs and adjust the treatment plan accordingly. They may also perform an ultrasound to check on the baby's development.
Strategies to prevent asthma complications during pregnancy include:
- seeing the doctor regularly
- taking medication as prescribed
- getting a flu shot, as the flu can trigger an asthma flare-up
- avoiding asthma triggers, including quitting smoking
- reducing stress, for example through yoga, mindfulness, or meditation
- eating small meals and not lying down immediately afterward to reduce the risk of heartburn, which can worsen asthma symptoms
- recognizing early signs of a flare-up and seeing the doctor when this happens
During pregnancy, asthma that is not well-managed can cause health complications for the woman and the baby. Preeclampsia, restricted growth, low birthweight, premature birth, and the need for a cesarean delivery become more likely.
Following a treatment plan is the best way to manage asthma symptoms.
Well-controlled asthma does not increase the risk of complications, and many women with asthma have healthy pregnancies.