Site icon Women Fitness

Asthma and Pregnancy

Asthma and Pregnancy

Pregnant women with asthma are not necessarily ‘high risk’ patients. In fact, asthma can follow a curious pattern in pregnant patients. One third of women experience no change in their asthma during pregnancy, one third actually notice an improvement when they are pregnant, and one third may experience a flare-up of their asthma during this time. Since there is no index to predict which way a patient will react, it is necessary to closely follow every pregnant asthma patient.

Most people are well aware of the myriad changes a body goes through during pregnancy – even the lungs go through interesting and intelligent alterations to adapt to the developing baby. In fact, one of the most confounding aspects of taking care of a pregnant patient is that it is normal for her to be short of breath. This makes it difficult to discern a ‘normal’ breathlessness from a problem that requires medication.

The Pregnant Body 

A woman’s body adjusts gradually as the pregnancy develops. Since a pregnant patient is carrying more weight, the lungs need to accommodate to the additional work of breathing caused by the weight gain. A pregnant woman breathes a little faster than normal, which is perfectly healthy. The body is raising what is called the minute ventilation

As the belly grows, it alters the shape of the bottom part of the chest. The chest is separated from the belly by a swathe of muscle called the diaphragm, which is a vital muscle that helps you to breathe. As the belly gains in girth, it pushes upwards against the diaphragm, preventing deep breaths and consequently increasing the respiratory rate. To make the chest a little bigger, the ribs splay outwards like bucket handles, letting the patient breathe a little deeper.

Remember, just because you have asthma does not mean that your baby will too – in fact, it’s more likely that he will not. You should be able to use your usual medications now that the baby is born, but always check with your doctor. Not only is it safe for the baby to breast-feed, breast-feeding is also beneficial to your newborn baby’s immune system. As your body recovers from the pregnancy and all the changes that happened in the lungs and chest normalize, your breathing will return to normal.

Can pregnancy ever trigger asthma for the first time?

Some women develop asthma for the first time during pregnancy. In some of the women who appear to have asthma for the first time, if you go into some detail in the medical history, you find that they probably had some previous asthma, it just was very mild or very intermittent, so it wasn’t noticed until now because the pregnancy seemed to make it worse.

Also, about a third of people with asthma may get worse during pregnancy and anywhere from a quarter to a third may find their asthma gets better during pregnancy. These changes that occur during pregnancy revert most of the time after delivery, or at least within the three months postpartum. So it does appear that it was really the pregnancy that did it.

Warning Symptoms

Asthma warning symptoms are the same when you are pregnant as when you are not. If you notice any of the following, visit your doctor immediately:

The main message here is – do not ignore symptoms, and talk with your doctor about any changes in your breathing. Your doctor may recommend a peak flow meter. This simple device measures airflow when you blow into it, and can be an important tool for monitoring asthma. Talk to your doctor about whether it is right for you.

Women with poorly treated asthma who are pregnant are at increased risk of suffering from uterine hemorrhage and vaginal bleeding. But the most frequent complication for the mother is a condition that can lead to premature delivery, or the need to induce delivery, sometimes before the fetus is viable.

Risks to the mother or poorly-treated asthma during pregnancy

The risks include :

Guidelines For Prescribing Newer Asthma Drugs During Pregnancy

A joint committee of the American College of Obstetricians and Gynecologists (ACOG) and the American College of Allergy, Asthma and Immunology (ACAAI) convened to provide guidance for physicians on asthma management in pregnant patients, particularly with regard to the use of newer asthma and allergy medications. The committee’s recommendations include:

In general, the committee preferred inhaled medications (because they have fewer systemic effects) and time-tested drugs (because of greater experience with their use during pregnancy). Physicians are advised to limit medication use as much as possible during the first trimester, although birth defects related to most asthma drugs are uncommon.


Step Therapy for Chronic Asthma During Pregnancy
Category Frequency/severity of symptoms Pulmonary function (untreated) Step therapy
Mild intermittent Symptoms no more than twice a week; nocturnal symptoms less than twice per mon

Top 10 Yoga Asana to relive Asthma

th; brief exacerbations (a few hours to a few days);asymptomatic between episodes.

as much as or more than 80%; normal pulmonary function between episodes Inhaled ß 2-agonists as needed.
Mild persistent Symptoms more than twice a week but persistent not daily; nocturnal symptoms more than twice per month; exacerbations affect activity. as much as or more than 80% Inhaled cromolyn; continue inhaled nedocromil in patients who had a good may response prior to pregnancy; substitute inhaled beclomethasone or budesonide if not adequate.
Moderate persistent Daily symptoms; nocturnal symptoms more than once per week; exacerbations affect activity. 60%– 80% Inhaled corticosteroids; if inhaled corticosteroids are initiated during pregnancy, use beclomethasone or budesonide; continue inhaled salmeterol in patients with a good response prior to pregnancy; add oral theophylline and/or inhaled salmeterol for patients inadequately controlled by medium-dose inhaled corticosteroids.
Severe persistent Continual symptoms; limited activity; frequent nocturnal symptoms; frequent acute exacerbations. less than 60% Treatment as described above, plus oral corticosteroids (burst for active symptoms; alternate day or daily, if necessary).
Adapted from Position statement: The use of newer asthma and allergy medications during pregnancy. 2000. [1]

Managing Asthma during pregnancy

There are two basic approaches that are both important in optimizing the mother’s health. First identify and avoid triggering factors that can worsen asthma; particularly dust mites, animal dander or mold. And then, since, most patients with persistent asthma can’t avoid enough of the triggering factors to have that suffice, to be on appropriate therapy. This is important because of their health and because there are risks from uncontrolled asthma to the baby’s health. Our study adds strength to the safety profile of the inhaled steroids, which are clearly the most effective preventative medicine relative to asthma.

Exit mobile version