ASTHMA AND PREGNANCY: WHAT YOU NEED TO KNOW, Nathan Fox, MD (Digital)
Asthma is a medical condition that women often experience during pregnancy. Pregnancy may affect asthma and may affect the outcomes of pregnancy. Here you will read everything you need to know about the relationship between asthma and pregnancy.
The Effects of Pregnancy on Asthma
The effects of pregnancy on asthma are various among women. Approximately one-third of women see an improvement in their asthma conditions and one-third see a worsening. The other one-third of women does not see any changes in their asthma symptoms. Women aren’t likely to experience asthma exacerbations, or shortness of breath, coughing, and wheezing, during labor.
Additionally, the changes in physiology during pregnancy do not significantly alter spirometry values in asthmatic patients. Spirometry is an excellent technique to detect and manage pregnant women with asthma. The values FVC (the total amount of air exhaled during a maximally forced effort) and FEV1 (the amount of air exhaled in the first second under force after inhaling), generally stay the same.
However, the vital capacity, total lung capacity, and FRC (the amount of air in the lungs at resting end of expiration) are reduced.
The Effects of Asthma on Pregnancy
Asthma has been shown to increase the risk of IUGR, or intrauterine grown restriction, which may carry the risk of impaired growth or perinatal morbidity. Asthma has also been associated with preterm birth and perinatal mortality.
However, these factors are most likely related to the amount of asthma control, and if well-controlled, these are less likely to have an increased risk of complications when compared to the general population.
Management of Asthma during Pregnancy
Asthma is managed similarly in pregnant patients and non-pregnant patients. The Working Group, an Asthma in Pregnancy of the National Asthma Education and Prevention Program (NAEPP), issued guidelines in 2007 on how to treat asthma in pregnancy. These steps include:
- Mild Intermittent: For asthma symptoms that occur two or fewer times per week. It is recommended to inhale short-acting beta-2 agonist as needed.
- Mild Persistent: For asthma symptoms that occur more than twice a week, but not daily. It is recommended to have a low dose inhaled glucocorticoid, which is a class of steroid hormones that are effective in treating asthma.
- Moderate Persistent: For patients experiencing daily asthma symptoms. The NAEPP recommends a medium dose of inhaled glucocorticoid, or a small dose of inhaled glucocorticoid, in addition to long-acting beta agonist. If needed, treatment may include a medium dose inhaled glucocorticoid, plus a long-acting beta agonist.
- Severe Persistent: For patients with asthma symptoms throughout the day, a high dose of inhaled glucocorticoid, plus a long-acting beta agonist.
Since there are many different approaches for treatment based on a woman’s specific asthma symptoms during pregnancy, it is always necessary to address these concerns with your healthcare professional for optimal treatment recommendations.
Preferred medications for pregnant women include Albuterol, Budenoside, and Salmeterol. However, there is no shown risk of using similar medications. Montelukast or Zafirlukast can also be considered for alternative medications as well.
Conclusion of Asthma and Pregnancy
Although asthma is a very common condition found in pregnancy, there are ways to treat symptoms, so it has a minimal impact on the health of your baby. To learn more about the relationship between asthma and pregnancy, please contact Maternal Fetal Medicine today.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!