Asthma is a chronic lung condition. If you’re pregnant, asthma can have an impact on your health and your baby’s health. Find out what you need to know about asthma and pregnancy.

Why is asthma during pregnancy a concern?

If you’re effectively treating your asthma and it’s well-controlled during pregnancy, there’s little or no risk of asthma-related complications. However, severe or poorly controlled asthma during pregnancy might increase the risk of various problems, including:

• A pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys (preeclampsia)
• Restricted fetal growth
• Premature birth
• The need for a C-section

In extreme cases, the baby’s life might be in jeopardy.

Can pregnancy make asthma worse?

Asthma is classified into four general categories, from least to most severe. While pregnancy can cause asthma to worsen, improve or remain unchanged, research suggests that asthma severity during pregnancy is related to asthma severity before pregnancy. Symptoms are more likely to worsen in people with severe asthma.

If asthma gets better, the improvement is generally gradual as the pregnancy progresses. If asthma worsens, the increase in symptoms is most noticeable during the first and third trimesters of pregnancy.

Some women might experience worse asthma signs and symptoms early in pregnancy because they stop taking their medications after becoming pregnant. Any changes you make to your medication routine might also influence the severity of your asthma.

Is it safe to take asthma medication during pregnancy?

Any medication you take during pregnancy can potentially have risks. Some concerns have been raised about the use of systemic glucocorticoids — a type of steroid — during pregnancy. They have been linked with an increased risk of infant oral clefts, preeclampsia, gestational diabetes, low birth weight and adrenal problems. However, most asthma medications can be safely used during pregnancy.

Also, it’s safer to take asthma medications during pregnancy than it is to experience asthma symptoms or an asthma attack. If you’re having trouble breathing, your baby might not get enough oxygen.

If you need medication to control your asthma symptoms during pregnancy, your health care provider will prescribe the safest medication at the most appropriate dosage. Take the medication as prescribed. Don’t stop taking the medication or adjust the dosage on your own. Depending on the type of medication you’re taking and your symptoms, your health care provider might be able to monitor your asthma control during your prenatal visits. In other cases, you might need to consult your family doctor or asthma specialist throughout the pregnancy.

Can I take allergy shots during pregnancy?

If you started a course of allergy shots before pregnancy, you can continue the shots during pregnancy. However, beginning a course of allergy shots during pregnancy isn’t recommended. Allergy shots can cause a dangerous allergic reaction known as anaphylaxis — especially early in the course of therapy. Anaphylaxis during pregnancy can be fatal for both mother and baby.

Will I need special tests?

If you have poorly controlled or moderate to severe asthma or you’re recovering from a severe asthma attack, your health care provider might recommend a series of ultrasounds starting at week 32 of your pregnancy to monitor your baby’s growth and activity.

Your health care provider might also recommend that you pay close attention to your baby’s activity level.

What should I do to prepare for pregnancy?

If you have asthma, schedule a preconception appointment with the health care provider who’ll be handling your pregnancy, as well as with your family doctor and an asthma specialist. They’ll evaluate how well you’re managing your asthma and consider any treatment changes you might need to make before pregnancy begins. Because asthma symptoms might increase during pregnancy, your health care team will closely monitor your condition.

What can I do to prevent complications?

Taking good care of yourself is the best way to take care of your baby. For example:

• Keep your prenatal appointments. Visit your health care provider regularly throughout your pregnancy. Share any questions or concerns you might have.
• Take your medication as prescribed. If you have concerns about the medications you’re taking, consult your health care provider.
• Don’t smoke. If you smoke, ask your health care provider to help you quit. Smoking can worsen asthma, and smoking during pregnancy can cause health problems for you and your baby.
• Avoid and control triggers. Avoid exposure to secondhand smoke and other potential irritants, such as dust and animal dander.
• Control gastroesophageal reflux disease (GERD). GERD — a chronic digestive disease that causes acid reflux and heartburn — can worsen asthma symptoms. If you develop GERD, you might be able to reduce your symptoms by elevating the head of your bed, eating smaller meals, waiting at least three hours after eating before lying down and avoiding foods that seem to trigger heartburn.
• Recognize warning signs. Make sure you know the early signs and symptoms that your asthma is getting worse, such as coughing, chest tightness, shortness of breath or wheezing. Talk to your health care provider about home treatments and when to seek medical help.

What about labor and delivery?

Most women don’t experience major asthma symptoms during labor and delivery. If you’re taking asthma medication, continue doing so during labor and delivery.

Will I be able to breast-feed my baby?

Breast-feeding is encouraged for women who have asthma — even if you take medication.

Will my baby have asthma?

A number of factors are thought to increase a person’s chances of developing asthma, including having a parent or sibling who has asthma and having a mother who smoked while pregnant. Be sure to talk to your baby’s doctor about any concerns you might have about your baby’s health.

April 22, 2020

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