With asthma being a very common medical condition, many women wonder how this diagnosis may affect their pregnancy. And with some women being afraid to take any unnecessary medications in pregnancy, they may think they should skip their asthma treatments if they haven’t had a flare in a while.
Asthma can be classified into categories based on how frequent daytime and nighttime symptoms are present. These categories range from mild to moderate to severe. We know that pregnant women who have mild asthma that is well-controlled should have no pregnancy complications, while those with asthma that is severe or poorly-controlled can run into a host of problems and are at higher risk of the following issues: preterm labor, preeclampsia, growth restriction in their babies, need for C-section, and maternal illness and even death.
Pregnancy can affect asthma differently. For example, about 25 percent of women will actually see an improvement in their symptoms, while 30 percent will have their asthma flare more. Therefore, it is important to continue to monitor your symptoms and report any changes to your doctor or midwife.
If you have asthma, your obstetric provider should routinely ask you how you feel your asthma is controlled. They may ask how often you need to use medications such as albuterol (a steroid that is used during an asthma flare to improve your breathing) as an indicator of how stable your asthma is. If your asthma appears to be worsening, they can check your lung function using something called a peak flow meter, which is a device you breathe into.
In each category of asthma, different medications are used to control symptoms and deal with flares. These medications are safe to use in pregnancy (as well as breastfeeding), and it is definitely preferable to take the proper medication and have good asthma control as opposed to foregoing the medication and having suboptimal control.
When it comes to monitoring baby, women who have moderate or severe asthma will usually undergo serial ultrasounds to monitor growth. This is because we know that poor asthma control can lead to growth issues in the developing baby. This is likely because during asthma flares, the oxygen flow to the placenta and thus the baby are decreased.
When it comes time to have your baby, women with asthma should be sure that the medications they have been on are continued while in the hospital. Only in rare cases is an early delivery needed because of asthma—this might occur if the woman is having a very severe flare and is intubated, for example.
Reviewed by Dr. Jen Lincoln, April 2020
- Asthma affects 4-8 percent of pregnant women.
- Women with severe or poorly controlled asthma are at increased risk for many obstetric complications.
- Some women have less asthma flares in pregnancy, while some have more.
- Safe medications to treat asthma exist and should be taken if prescribed.