Asthma affects four to eight percent of pregnant women. Poorly controlled asthma is associated with low infant birth weight, preeclampsia and the risk of preterm delivery, but can be well-controlled to help ensure good fetal oxygenation to achieve the same fetal outcomes as those women not afflicted with asthma. In pregnant women, good asthma control, including maintenance and education, such as proper use of a spacer and peak flow meter, compliance with treatment and response to asthma symptoms, are important for the expectant mother and baby.
Asthma may change in severity, for better or worse, during pregnancy, but there is no way to know which it will be in each case. A recent study in Sweden of more than one million pregnant women over several decades has shown that those with severe asthma have a significantly increased chance of adverse fetal outcomes compared to those with mild or moderate asthma who can expect excellent outcomes.
The goal is always adequate oxygenation of the baby through the prevention of low oxygen levels in the expectant mother, who can already have compromised breathing due to the following:
- The baby taking up space and causing limited rib-cage expansion, making it hard to take deep breaths
- Acid reflux can occur or worsen during pregnancy, contributing to asthma symptoms and exacerbations, making it even more important to keep symptoms in check.
According to the American College of Obstetricians and Gynecologists and the National Asthma Education and Prevention Program (NAEPP) it is better for a pregnant woman to be treated with asthma medications than to have asthma symptoms. Short-acting bronchodilators should be used as a rescue medication for pregnant women having acute asthma symptoms.
Inhaled corticosteroids (ICS) are the standard for keeping asthma in check and controlled during pregnancy. There are specific inhaled corticosteroids that are considered safe for use during pregnancy, so speak to your doctor. Long-acting bronchodilators may be used in conjunction with ICS if adequate control is not achieved with ICS alone.
NAEPP guidelines also recommend monthly pulmonary function tests, including spirometry and use of peak flow meters to monitor lung function during pregnancy.
Managing your asthma while pregnant can be easy and uneventful if you follow the recommendations of your physician. With a little planning you can achieve peace of mind while you are awaiting the arrival of your bundle of joy. If you would like an education session regarding the use of spacers and peak flow meters, please call Breathe Pennsylvania at 1-800-220-1990 and we will be more than happy to help!