How does asthma affect pregnancy?

Asthma is one of the most common health complications of pregnancy. For many expectant mothers, this presents special challenges.

There is no way to predict how pregnancy will affect your asthma symptoms. Some expectant mothers find that asthma symptoms improve during pregnancy. Others say they worsen or remain the same.

As pregnancy progresses, there is less room inside your body to take a full, deep breath. Normal activities such as climbing stairs may leave you short of breath. Yet, they should not make you cough, wheeze or experience reduced breathing levels. (Use a handheld peak flow meter to check.)

Learn the difference between breathing changes due to pregnancy and symptoms of asthma. If breathing symptoms improve after using your inhaler, then symptoms are likely due to asthma. You should report this immediately to your obstetrician, allergist or other healthcare provider.

What asthma complications can occur during pregnancy?

Asthma is a serious and potentially life-threatening condition. This does not mean you can’t enjoy a healthy pregnancy and delivery. The key to remember is that healthy breathing is vital to a healthy pregnancy! Your unborn baby depends on you for a constant fresh air supply. Asthma symptoms such as coughing, wheezing, shortness of breath, or gasping for air are warning signs that your baby’s air supply may be at risk.

If asthma symptoms are ignored or left untreated, expectant mothers are at increased risk of complications. One of these complications is pre-eclampsia. Pre-eclampsia is a group of symptoms including high blood pressure, ankle swelling, and kidney problems. Pre-eclampsia may compromise the growth and health of your baby. It may also progress to seizures and other serious consequences. These may include excessive vomiting, vaginal bleeding, and premature or complicated labor.

For your unborn baby, poorly controlled asthma symptoms can be dangerous. They may cause slowed growth, preterm birth, low birth weight, low oxygen levels at birth, or even loss of life.

How is asthma controlled during pregnancy?

The good news is that asthma complications during pregnancy can be prevented. It is crucial to have good asthma control to protect you and your baby. Asthma symptoms can be treated and, in most cases, prevented during pregnancy.

You will need a written Asthma Action Plan. You develop this plan with your asthma specialist and your obstetrician. 

Along with taking medications as prescribed, environmental control is key to managing asthma. Expectant moms must be extra careful to avoid anything that might lead to an asthma flare. It is important to practice allergen and irritant avoidance measures. This may include staying inside on high pollen days and keeping your windows closed. It may help to install dust mite covers on mattresses and pillows. It is also important to get rid of mold from the home and workplace

Even when you are not having asthma symptoms, it is possible unhealthy breathing. Check your breathing levels at home each day using a handheld peak flow meter. At asthma care appointments your breathing levels should be checked using a spirometer. Seek expert obstetric and asthma care throughout pregnancy.

Can you take asthma medication while pregnant?

It is best to be cautious using any medication during pregnancy. Yet, most asthma medications are considered safe for both mother and baby. This is according to the American College of Allergy, Asthma & Immunology.

The goal in using medications is to prevent asthma inflammation and treat symptoms when they first begin. This approach minimizes risks and maximizes benefits to both you and your baby.

Your doctor will determine if there are any medication risks. Your doctor will help you carefully balance your medication use and symptom control. They can also review the potential risks verses benefits of the medications you take.

Inhaled medications are often recommended for pregnant women with asthma. They go to the airways in smaller doses and only a small amount enters the bloodstream.

Are there natural remedies for asthma during pregnancy?

Herbal and dietary supplements are not well studied in expectant mothers. You should not use these without supervision from your healthcare providers.

You should not use any medication or supplement without checking with your healthcare provider. They can help you understand the risks versus benefits. All care, including medication use, must be coordinated with your obstetrician.

See article: Ask the Allergist: Asthma and Pregnancy

How is asthma managed during labor and delivery?

Most expectant mothers with asthma deliver healthy, full-term babies . Most do not experience any breathing problems during labor or delivery. Do not stop any of your medications when labor starts unless directed otherwise by your healthcare provider. Your physician may direct you to bring a bronchodilator with you into the delivery or birthing room.

Depending on your health at the time you go into labor, your healthcare provider may give you oxygen through a mask. You may alse be given intravenous fluids to keep you well hydrated. Your physician will monitor contractions, your breathing and heart rate. They will also check the baby’s heart rate and other vital signs.

If have trouble breathing during labor or delivery, the health care provider can give you medications. Inhaled medications may be given through an oxygen mask. They may also give intravenous medications with the intravenous fluids.

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How do I monitor my daily asthma symptoms?

National asthma guidelines suggest using a daily symptom diary such as Allergy & Asthma Network’s AsthmaTracker™ to keep track of symptoms, peak expiratory flow rates (if you or your child use a peak flow meter) and medications used.

What is an AsthmaTracker?

The AsthmaTracker™ can help your track how well your symptoms respond to your treatment plan. By writing down your symptoms, peak expiratory flow rate and medication use each day, you’ll notice a pattern to your symptoms and develop strategies to stop the symptoms before they can stop you.

What is a peak flow meter?

A peak flow meter is a handheld device that measures the peak expiratory flow rate (PEFR), or how much air you can forcibly push out of your lungs at a particular time.

Asthma Storylines – an app for managing asthma

The free Asthma Storylines app is a self-care tool for managing asthma. Track symptoms, learn more about daily patterns and record topics to discuss with your healthcare team.

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Image of doctor holding up phone towards camera. The phone has the Asthma Storyline app on it.

Are there other conditions that may look like asthma or complicate asthma?

There are other types of respiratory conditions that are different than asthma.  The symptoms, diagnosis and treatment can vary depending upon the condition. Here are some of them.

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COPD

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respiratory syncytial virus (RSV)

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alpha-1 antitrypsin deficiency

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COVID-19

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sleep apnea

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bronchiectasis

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influenza, infections and viruses

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Vocal cord dysfunction