Asthma During Pregnancy: Things You Should Know As You Plan A Baby

If you have a history of asthma, you may be wary of what will happen if you get pregnant. Asthma affects 4–12% of pregnant women, causing airways to swell up and triggering symptoms like shortness of breath, coughing, chest tightness, and wheezing.¹ But can asthma intensify during pregnancy or, worse still, affect your child’s development? Here’s what you need to know.

Asthma Severity During Pregnancy Varies From Woman To Woman

[pullquote]It’s likely that your asthma symptoms or episodes in this pregnancy will mirror a previous one. If your asthma intensified during a previous pregnancy, gear up with the right treatment plan even as you plan your next pregnancy.²[/pullquote]

Pregnancy can have varying effects on women with asthma. Over a third of women with this condition experience no change in their symptoms while another third experience a worsening of the condition. Less than one-third of women may find that their symptoms improve during pregnancy. While each case is different, it’s more likely for women with severe asthma to experience a worsening of the condition. Some women may also see more symptoms as the pregnancy progresses and there’s weight gain. In fact, you are most likely to experience an aggravation in the condition, if any, between 24 and 36 weeks.^{3 4}

Unregulated Asthma Can Cause Serious Health Risks During Pregnancy

So how does pregnancy affect your asthma? Hormonal changes due to pregnancy can impact your lungs, sinuses, and nose. An increase in estrogen can cause the blood vessels in the nose to get congested, leading to a stuffy nose. Meanwhile, an increase in progesterone results in an increased respiratory drive and may, therefore, leave you feeling short of breath.⁵ While these changes tend to affect most pregnant women, asthmatics might feel them more acutely. These may even aggravate other triggers.

But there is good news. As long as your asthma is controlled with medicines and is monitored carefully, it shouldn’t cause any problems. Your doctor will be able to step up treatment based on how you are doing. Uncontrolled asthma, on the other hand, can have serious implications.

Possible complications due to uncontrolled asthma for the mother include:

• Gestational hypertension or high blood pressure
• Preeclampsia which is characterized by high blood pressure, protein in the urine, and water retention
• Vaginal hemorrhage or bleeding
• Hyperemesis gravidarum, which is characterized by weight loss, severe vomiting, and electrolyte and fluid imbalances⁶

Possible complications due to uncontrolled asthma for the baby include:

• Poor growth in the womb or Intrauterine growth retardation
• Premature birth
• Low birthweight
• Insufficient oxygen or neonatal hypoxia
• Stillbirth⁷

Continue Using Asthma Medication Under A Doctor’s Supervision

Pregnancy is a time when you are wary of any medication and its effect on your baby. So can asthma medication cause any problems? Around 3% of pregnant women use asthma medication such as anti-inflammatory drugs or bronchodilators. While some research indicates a possible link between asthma medication and a higher risk for certain birth defects such as anorectal atresia (defect of the anus), esophageal atresia (defect of the food tube), and omphalocele (abdominal wall defect), the researchers have been quick to point out that this may be a chance finding. They also suggested that it was possible that the asthma itself or health issues related to it might be responsible for the higher risk rather than the asthma medicine.^{8 9}

[pullquote]Consult your doctor even as you plan your pregnancy for the right medication and guidance. Stay on schedule with these meds and follow up with regular check-ups to keep your asthma under control.[/pullquote]

On the whole, while safety studies on asthma medication during pregnancy is limited, the medical consensus is that women with asthma can safely use their medication and should continue to do so. In general, medications such as short-acting inhaled bronchodilators, inhaled corticosteroids like budesonide, and anti-leukotriene agents like montelukast are considered to be safe for use during pregnancy. Long-acting beta-agonists and oral steroids, on the other hand, are only considered if the asthma is very severe.¹⁰ What’s critical is that you work with your doctor to ensure that your asthma remains under control. Your doctor may tweak your treatment plan or switch medicines based on how you are faring during pregnancy.

Take Steps To Lower Chances Of An Asthma Attack

Go the extra mile to reduce the chances of getting an asthma attack during pregnancy. Here’s what you can do:

• Avoid triggers. Steer clear of substances like tobacco smoke, dust mites, or other irritants which can trigger an attack. Make your home an irritant-free zone – use allergy-proof covers on bedding, remove carpets which can gather irritants, vacuum regularly, and get a high-efficiency particulate air filter and a dehumidifier to help control mold.¹¹
• Take asthma medication as prescribed by your doctor throughout your pregnancy.
• Moderate exercise can be beneficial but check with your doctor before starting an exercise program.
• Get your flu shot as pregnancy as well as asthma can increase the risk of complications due to flu. Getting the flu vaccine during pregnancy will also afford your baby protection from flu for the first few months after birth.^{12 13}
• Have anti-asthmatic foods like apples, oranges, and tomatoes. These common food items may help you deal better and even thwart an episode. Apples, for instance, are good for your pulmonary health – they can reduce bronchial hypersensitivity and your risk for asthma due to the presence of beneficial flavonoids in them. Oranges have also been found to have a beneficial effect.¹⁴ Tomatoes, on the other hand, can reduce white blood cells (neutrophils) which trigger inflammation of the airways. The antioxidant compound known as lycopene is thought to be responsible for this beneficial effect.¹⁵

An Asthma Attack During Labor Is Very Rare, So Breathe Easy

Asthma attacks are extremely rare during labor especially when your asthma is under control. Hormones such as adrenaline and cortisone which are produced by the body during labor may also help ward off asthma attacks.^{16 17}

During pregnancy, seek immediate medical attention if

• Your current medication doesn’t improve symptoms quickly or if the improvement doesn’t last as long as it once did.
• You have trouble breathing.
• Fetal kick count reduces.¹⁸