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What to Know About Asthma and Pregnancy

Medically Reviewed by Hansa D. Bhargava, MD on October 08, 2020

Your asthma can get better, get worse, or stay the same when you're pregnant. If it does improve, that can happen throughout the pregnancy.

If you have severe asthma, it's more likely to get worse. You may feel this during the first and third trimester.

If your symptoms change, your doctor needs to know. This allows them to adjust your medication throughout your pregnancy. They may monitor your lungs as well.

Managing your asthma keeps you and your baby healthy. When you have trouble breathing, it's hard for them to get the oxygen they need. This is especially important since there's a link between asthma attacks during the first trimester and birth defects.

Watch out for symptoms such as:

  • Hard time catching your breath
  • Wheezing, which can sound like whistling
  • Tight feeling in chest
  • Coughing

Keeping Asthma Under Control

There are risks to taking any medication when you're pregnant. Doctors believe the benefits outweigh the dangers for women with asthma. Controlling your condition can lower your chance of problems like preterm delivery and labor, birthweight of less than 5.5 pounds, gestational diabetes, and preeclampsia -- a complication during pregnancy involving high blood pressure and other symptoms.

Budesonide is a daily inhaled steroid that is safer for pregnant women. Albuterol is a short-acting medicine that can get rid of symptoms fast and also has few risks.

Montelukast (Singulair) and zafirlukast (Accolate) are also safer medications for ongoing asthma control. You shouldn't start omalizumab (Xolair), but you can keep using it if you took it before you got pregnant.

If you were getting allergy shots before you got pregnant, you can keep up with them, but let your allergist know you're pregnant. You shouldn't start them once you're pregnant.

You should only use steroid medicines you take by mouth for severe asthma attacks, not everyday treatment. Always check with your doctor before taking these. They can cause low birth weight and preterm delivery.

Smoking can set off your asthma and is dangerous for your baby. You should quit if you're pregnant or want to become pregnant.

Possible Complications

Asthma can raise your chances of getting problems during pregnancy such as:

  • Placental abruption (placenta separates from wall of uterus)
  • Preeclampsia
  • Placenta previa (placenta covers all or part of the cervix)
  • Obstetric hemorrhage (excessive bleeding before or after delivery)
  • Spontaneous abortion
  • Pulmonary embolism (blockage in lung artery)
  • Gestational diabetes
  • Respiratory viral infections
  • Preterm birth, low birthweight, and cesarean delivery, especially if you have severe or uncontrolled asthma

You may also get rhinitis, which gives you a runny, stuffy nose and can make you sneeze. Colds are often the cause of rhinitis, and pregnant women with asthma may be more likely to catch them.

If you get gastroesophageal reflux disease (GERD), it can be more intense when you're pregnant. To feel better, try to reduce your meal size and stay away from foods that give you heartburn. After you eat, don't lie down until 3 hours or more have passed. When you do, try raising the head of your bed.

Rhinitis and GERD can make it harder for you to manage your asthma. So can sinusitis, which you're more likely to get when you have a cold.

Staying Healthy

You're more likely to have an asthma attack during weeks 24 through 36 of pregnancy. You can help prevent them at any point while you're pregnant by taking your medication and staying away from triggers.

Try to avoid asthma triggers in the air. Things like strong scents from paint and perfume, air pollution, smoke, and cold air can irritate your lungs. It's also important to avoid traffic pollution during the first trimester. It might cause preterm birth and preeclampsia.

Allergens such as dander from pets, dust mites, cockroaches, and molds can cause symptoms, too. Avoiding these can also help with allergic rhinitis. You should also watch out for infections like the common cold and flu.

Physical activity shouldn't be a trigger if your asthma medication is working. If exercising does cause symptoms, talk to your doctor.

Labor and Delivery

Very few women have asthma symptoms while giving birth. You can work with your doctor to create a delivery plan. You can also ask them about breastfeeding while taking your medication. If you have a hard time breathing during labor, belly breathing exercises may help you calm down.

Your baby may be more likely to have asthma since you do, but other factors are involved too.

WebMD Medical Reference

Sources

SOURCES:

Mayo Clinic: "Pregnancy and asthma: Managing your symptoms," "Budesonide (Inhalation Route)," "Albuterol (Inhalation Route)," "Montelukast (Oral Route)," "Zafirlukast (Oral Route)," "Theophylline (Oral Route)," "Omalizumab (Subcutaneous Route)," "Asthma attack."

American Academy of Allergy, Asthma & Immunology: "Asthma and Pregnancy," "Women With Asthma Can Have Healthy Pregnancies," "Asthma Overview," "Short-Acting Beta-Agonists Definition,"

March of Dimes: "Asthma During Pregnancy."

University of Pittsburgh Medical Center: "Newborn Congenital Anomalies."

Chest: "Asthma Outcomes and Management During Pregnancy."

Merck Manual: "Rhinitis."

CDC: "Sinus Infection (Sinusitis)."

American Lung Association: "Asthma and Pregnancy."

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