Pregnancy and Asthma

Every woman reacts to pregnancy differently. In pregnant women with asthma, asthma control improves in about 1 in every 3 women, worsens in about 1 in every 3 women and remains the same in about 1 in every 3 women.

Worsening of asthma symptoms can happen at any stage of pregnancy, but it seems to be most common between 17 and 36 weeks, mainly in the 6th month of pregnancy.


Signs that your asthma may be getting worse include:

  •  a cough that is worse at night or in the early morning, or when you exercise
  •  wheezing
  •  breathlessness
  •  tightness in your chest

If you have these symptoms, speak to your doctor or asthma specialist, who will advise you on the best treatment.


Signs of a severe asthma attack include:

  •   severe difficulty with breathing, walking or talking
  •   lips or skin turning blue
  •   exhausted and tired due to the effort of breathing
  •   wheezing stops suddenly

If you experience any of the signs of a severe asthma attack, dial 111 to ask for an ambulance and use blue reliever


How to prepare?

If you have asthma, schedule a preconception appointment with the health care provider who'll be handling your pregnancy, as well as with your family doctor and an asthma specialist. They'll evaluate how well you're managing your asthma and consider any treatment changes you might need to make before pregnancy begins. Because asthma symptoms might increase during pregnancy, your health care team will closely monitor your condition.


Why is asthma during pregnancy a concern?

If you're effectively treating your asthma and it's well-controlled during pregnancy, there's little or no risk of asthma-related complications. However, severe or poorly controlled asthma during pregnancy might increase the risk of various problems, including:

A pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys (preeclampsia)

  •  Restricted fetal growth
  •  Premature birth
  •  The need for a C-section


Is it safe to take asthma medication during pregnancy?

Any medication you take during pregnancy can affect your baby, but the majority of asthma treatments are safe to use when you are pregnant. Medical experts advise that it is far safer to manage your asthma with medicine than it is to leave asthma untreated during pregnancy. Keep taking your asthma medication as normal unless instructed to do otherwise by your doctor.


Steroid tablets

Steroid tablets contain larger amounts of medication than a preventer inhaler.

They are prescribed by your doctor for a short time if your asthma gets worse.

Steroid tablets work to reduce the inflammation in your airways, and are safe to take during pregnancy.


What can I do to manage my asthma during pregnancy?

Taking good care of yourself is the best way to take care of your baby. For example:

Keep your prenatal appointments. Visit your health care provider regularly throughout your pregnancy. Share any questions or concerns you might have.

Take your medication as prescribed. If you have concerns about the medications you're taking, consult your health care provider.

 If you smoke, ask your health care provider to help you quit. Smoking can worsen asthma, and smoking during pregnancy can cause health problems for you and your baby.

Avoid and control triggers. Avoid exposure to secondhand smoke and other potential irritants, such as dust and animal dander.

Control gastroesophageal reflux disease (GERD). GERD — a chronic digestive disease that causes acid reflux and heartburn — can worsen asthma symptoms. If you develop GERD, you might be able to reduce your symptoms by elevating the head of your bed, eating smaller meals, waiting at least three hours after eating before lying down and avoiding foods that seem to trigger heartburn.


What about labour and delivery?

Most women do not get severe asthma symptoms during labour and delivery. Some women may be advised to have continuous monitoring of the foetus during labour and delivery. If you are taking asthma medication, continue doing so during labor and delivery. During labour and delivery you have the same choice of pain medication as any woman.


What happens when I Breastfeed?

Your inhaled Asthma medications are not found in breast milk, and even if you have to use steroid tablets the small quantities that are found in breast milk will not have any harmful effect on your baby. Breastfeeding can decrease risk of asthma for children.


What can I do during pregnancy to reduce the chance of my baby having Asthma?

Smoking during pregnancy increases the risk of your baby developing Asthma, bronchitis and wheezing illness. Exposure to second-hand tobacco smoke exposure after birth also increases the risk of poor respiratory health. It is unclear whether smoking during pregnancy affects the risk of allergies.

If you have food allergies yourself, continue to avoid these foods for your own health. It is important to let your doctor or midwife know so that they can check that you are still getting the right nutrition for you and your baby.

New Zealand research has shown that babies who were born in a farming environment and therefore exposed prenatally to farm animals were protected against childhood Asthma, hay fever and eczema. Children exposed to cats and dogs, and those from larger families also appear to have a lower risk of allergies.


By Elayne Jiang