Asthma is the most common, potentially serious medical condition to complicate pregnancy. Well-controlled asthma is not associated with significant risk to the mother or the fetus. However, uncontrolled asthma can cause serious complications to the mother. However, asthma can be controlled by careful medical management and avoidance of known triggers, so asthma should not be a reason to avoid pregnancy.
Relationship of Asthma and Pregnancy
Although studies vary widely on the overall effect of pregnancy on asthma, several reviews find the following similar trends:
- Women with severe asthma are more likely to worsen, while those with mild asthma are more likely to improve or remain unchanged.
- The change in the course of asthma in an individual woman during pregnancy tends to be similar on successive pregnancies.
- Asthma exacerbations are most likely to appear during the weeks 24 to 36 of gestation, with only occasional patients becoming symptomatic during labor and delivery.
- The changes in asthma noted during pregnancy usually return to pre-pregnancy status within three months of delivery.
- Pregnancy may affect asthmatic patients in several ways. Hormonal changes that occur during pregnancy may affect both the nose and sinuses, as well as the lungs. An increase in the hormone estrogen contributes to congestion of the capillaries (tiny blood vessels) in the lining of the nose, which in turn leads to a “stuffy” nose in pregnancy (especially during the third trimester). A rise in progesterone causes increased respiratory drive, and a feeling of shortness of breath may be experienced as a result of this hormonal increase.
Asthma is a disease in which intensity of symptoms can vary from day to day, month to month, or season to season regardless of pregnancy. Therefore, a treatment plan should be chosen based both on asthma severity and experience during pregnancy with those medications. Always remember that the use of medications should not replace avoidance of allergens or irritants, as avoidance will potentially reduce medication needs.
Can any of the medications I take for my asthma cause harm to my baby?
Most medications used to treat asthma appear to be safe, especially those that have been around for many years and have been time tested. Unfortunately, it is very difficult to do adequate studies in pregnant women to prove the safety of drugs.
Will asthma have any effect on my pregnancy and on the baby?
If uncontrolled, severe asthma may be harmful to the developing fetus. However, if well-controlled, it should not have adverse effect on you or your baby.
How does severe, uncontrolled asthma adversely affect the fetus?
The developing fetus depends on the mother to supply oxygen for growth and survival. Oxygen dissolved in her blood is transferred through the placenta to the fetus. Uncontrolled asthma causes a decrease in the mother’s oxygen which reduces the oxygen available to the developing fetus. This may result in impaired fetal growth; it could even affect survival of the fetus.
Will my asthma worsen during pregnancy? Is there any greater risk during labor and delivery?
Your asthma may worsen, stay unchanged or possibly improve during pregnancy. Although it cannot be accurately predicted in a first pregnancy, asthma usually follows the same course in subsequent pregnancies. For reasons not totally understood, asthma usually improves during labor and delivery, but even if a severe attack occurs then, appropriate treatment can be given, and complications are rare.
Can asthma medications safely be used during pregnancy?
Though no medication has been proven entirely safe for use during pregnancy, your doctor will carefully balance medication use and symptom control. Your treatment plan will be individualized so that potential benefits of medications outweigh the potential risks of these medications or of uncontrolled asthma.
Treatment with Dr.Shukla
Dr. Shukla of Brooklyn New York has been in practice for more than 15 years. He has provided the answers and treatments to many suffering from asthma, allergies, and sleep apnea. Here at the Asthma, Allergy and Sleep Center of New York, we provide you with a personalized, boutique approach to health care and pediatric pulmonology all under one roof. We emphasize prevention and use our advanced diagnostic technologies to give you and your child the best possible care. If you have questions regarding the relationship between asthma and pregnancy, contact us here today!
