Asthma During Pregnancy

Asthma is a lung disease with chronic airway inflammation, causing your airway to tighten up and making it hard to breathe. There is no cure for asthma and severe symptoms can happen any time. However, most people can manage their asthma and keep it under control. If you are pregnant and have asthma, it’s important to work with your doctor to manage it and get medical care when needed.

If your asthma is uncontrolled, you may be at risk for developing high blood pressure and preeclampsia, a serious blood pressure disorder that occurs after 20 weeks of pregnancy, with signs of damage to organ systems, including the kidneys, liver, blood or brain. Uncontrolled asthma may also mean your baby is not getting enough oxygen, increasing the risk for several health conditions including:

• Premature birth
• Poor growth
• Low birth weight
• Complicated labor

Asthma is managed during pregnancy through monitoring lung function, avoiding and controlling asthma triggers, using individualized pharmacologic therapies and staying educated about your condition.

Asthma can be hard to diagnose, so your doctor will need to diagnose you by taking your health history, doing a physical exam and listening to your breathing. He or she may have you take a spirometry, a kind of lung function test where you exhale into a machine called a spirometer. The machine measures the amount of air you breathe and how fast you can breathe. When you’re pregnant, normal changes in your body can make you short of breath. This test can help determine if your shortness of breath is caused by asthma or not.

How Often Does Asthma During Pregnancy Happen?

Asthma affects  4 to 8 percent of pregnancies. Around 30 percent of women who had asthma prior to pregnancy experienced worsened asthma while pregnant.

What Are Some Symptoms of Asthma During Pregnancy?

Some of the signs and symptoms of asthma include:

• Chest tightness or pain
• Coughing
• Shortness of breath
• Wheezing

Because uncontrolled or severe asthma can affect your baby, it is important to pay attention to signs of worsening asthma. Signs that your asthma could be worsening include:

• Asthma symptoms becoming more frequent and more bothersome
• Increased difficulty breathing
• The need to use an inhaler more frequently

What Are Some Causes of Asthma During Pregnancy?

Multiple things can trigger asthma symptoms, and the triggers can be different, depending on the person. However, some of the most common asthma triggers include:

• Allergens: About 70 percent of people with asthma have allergies. Allergens are the things that cause you to have allergy symptoms, such as sneezing, getting a rash or having trouble breathing. Common allergens are pollen, molds, animal dander, cockroaches and dust mites. Your provider may prescribe you an allergy medicine. If you receive allergy shots prior to pregnancy, it is safe to keep taking them during pregnancy. If you have not received them, do not start taking them while pregnant – it can cause anaphylaxis, a serious allergic reaction.
• Irritants: Irritants are things in the environment that can hurt your lungs, including air pollution, cigarette smoke, smoke from wood-burning stoves or fireplaces, cold air and certain strong smells, such as paint or perfumes. These can also include irritants found at certain workplaces, including chemical fumes, gases and dust.
• Exercise: Exercise can trigger asthma symptoms in some people, and may be worse if the air is cold and dry. If your asthma is controlled, you most likely can exercise without any issues. If exercising during pregnancy triggers your asthma, speak with your doctor.
• Infections: Infections such as a cold, the flu, or viral pneumonia can trigger asthma symptoms in some people.

How Can Asthma During Pregnancy Be Treated?

Pregnant women manage their asthma the same way nonpregnant women do. However, special considerations and attention should be taken when you are pregnant to avoid any complications.

Some of the measures you can take to best manage your symptoms include:

• Avoid your asthma triggers. Avoid people who are sick with respiratory infections. Avoid exposure to secondhand smoke and other allergens such as dust mites, animal dander, pollen, and mold. Your doctor can help you determine what specific allergens trigger your symptoms so you can best avoid them. If physical activity is a trigger for your asthma, speak with your doctor about ways to remain active throughout pregnancy while reducing asthma symptoms.
• Take your medication as prescribed. If you were taking asthma medication before becoming pregnant, don’t stop taking it without speaking to your doctor. If you are diagnosed with asthma after becoming pregnant, your doctor may prescribe you asthma medicine. He or she will prescribe the safest medication at the most appropriate dosage for your condition.
• Have regular prenatal appointments. Visit your doctor regularly throughout your pregnancy. Share any questions or concerns you might have. Keeping your doctor informed and up to date about your condition will help her or him know how to best manage your symptoms and ensure a healthy pregnancy.
• Don’t smoke. Smoking while pregnant can cause health issues for you and your baby, but smoking can worsen asthma, causing more acute risks for you and your baby.
• Recognize the warning signs. Staying aware and informed of your condition is the best way to help manage it. Make sure you know the early signs and symptoms of worsening asthma, such as more frequent and more severe coughing, chest tightness, shortness of breath or wheezing.

When Should I See My Doctor for Asthma During Pregnancy?

Your doctor will need to monitor your lungs throughout your pregnancy and adjust medications as needed. Keeping regular health care appointments is a must. Other reasons you should see your doctor include:

• If you think you have developed asthma. If you were not previously diagnosed with asthma, but after becoming pregnant are experiencing frequent coughing or wheezing that lasts more than a few days or any other symptoms of asthma, see your doctor. Treating asthma early can prevent long-term lung damage and help keep it from worsening over time.
• To review your treatment. Your asthma symptoms and triggers may change over time and throughout your pregnancy. Your doctor may need to then adjust your treatment. See your doctor regularly to discuss any changes in your asthma and overall health.
• If your asthma symptoms get worse. Call your doctor immediately if your medication doesn't ease your symptoms or if you need to use your inhaler more often. Do not take more medication without first consulting your doctor. Overusing asthma medication can cause adverse side effects and may make your asthma worse.

If you were previously diagnosed with asthma or develop it during pregnancy, it is important to pay attention to worsening symptoms. Severe asthma attacks can be life-threatening. While your doctor can help you manage your symptoms in the long term, you may experience an asthma attack that requires emergency treatment. Signs of an asthma emergency include:

• Rapid worsening of wheezing or shortness of breath
• No improvement after using a quick-relief inhaler
• Shortness of breath when doing minimal physical activity

Seek emergency treatment if you experience any of these symptoms. Speak with your doctor to develop an action plan in the case of such an emergency.

Learn more about Multidisciplinary Obstetric Medicine Service (MOMS) at Lifespan