Pregnancy can be a difficult time for many women, but especially for those with the added burden of asthma.
Asthma, a chronic disease of the airways of the lungs, is one of the most common medical problems that occurs during pregnancy. Sonali Bose, MD, a pulmonologist at the Mount Sinai – National Jewish Health Respiratory Institute, explains how asthma can affect both the mother and child, and what you can do about it.
Why is my asthma worse when I am pregnant?
Asthma control during pregnancy can be unpredictable. Asthma may get worse during pregnancy because of the effects of hormonal changes associated with pregnancy. Some experts have proposed that changes in the hormone progesterone can have effects on the mother’s airways, such as influencing airway inflammation or its sensitivity, but the exact mechanisms are still unclear.
Another major reason that asthma may get worse during pregnancy is that many pregnant women tend to stop or decrease their asthma medications because they are worried about how these medications may affect their unborn child, which in turn may cause the mothers to have worse control of their asthma.
What are the symptoms of asthma during pregnancy?
Women with asthma may have variable symptoms over the course of their pregnancy. Women with poorly controlled asthma may have more severe respiratory symptoms, such as wheeze, chest tightness, or cough. Some women may be more likely to have an asthma attack, either during the pregnancy or even after delivery.
Is asthma dangerous during pregnancy?
Asthma is a serious disease for all patients, not just pregnant women. However, asthma control can get worse with pregnancy. The detrimental effects of asthma not only affect the mother, but we are increasingly discovering their serious effects on the health and development of the unborn child.
Women with uncontrolled asthma during pregnancy have been reported to have more complications, such as preeclampsia, pregnancy-induced hypertension, and preterm labor. Uncontrolled asthma during pregnancy may lead to poor growth of the fetus and low birth weight. But we need better research studies to improve our understanding of exactly how asthma during pregnancy affects both the mother and child.
Can asthma be transferred from mother to child?
Asthma does run in families. Children of mothers with uncontrolled asthma (for example, those who have had an asthma attack during pregnancy) may have a higher risk of developing asthma and other allergic diseases and chest infections, or have lower lung function during childhood.
How is asthma treated during pregnancy?
The goal for treating asthma during pregnancy is similar to that for patients who are not pregnant: focus on improving asthma control. Inhaled corticosteroids are still the main way of helping control asthma during pregnancy and are effective in treating airway inflammation and preventing an exacerbation. These inhalers appear to be safe in pregnancy, and any risks are thought to be outweighed by the benefits of achieving good asthma control.
However, if an exacerbation occurs, oral steroids may be needed to treat it. In addition, we advise that pregnant mothers try to avoid their known environmental triggers and follow universal precautions to avoid contracting a respiratory infection. It is important to optimize asthma control even before becoming pregnant, because it seems that women who have more severe asthma before getting pregnant may be more vulnerable to having problems during their pregnancy.