Asthma in Pregnancy

This is the tenth post of our mini-series about asthma based on our patient booklet “Fast Facts for Patients and their Supporters: Asthma”. Here, we focus on asthma in pregnancy.

Asthma rarely occurs for the first time during pregnancy, but it may reappear during pregnancy if you had it as a child. About a third of women find that their symptoms get worse during pregnancy. This is usually because they stop taking their preventer medication.

It is important to keep your asthma well controlled. An asthma attack during pregnancy can harm both you and your unborn child. Reduce the risk of attacks by taking your preventer medication as prescribed. Also, the better you control your asthma during pregnancy the less chance your child has of developing asthma in the early years of life.

If your symptoms are very well controlled, your doctor may reduce your medications, although it is best to keep taking a preventer.

Most asthma medications are safe in pregnancy and won’t harm your baby. However, if you are taking add-on treatments, they will need to be reviewed and may have to be stopped until after the birth.

“It is important to keep your asthma well controlled.”

How Will Pregnancy Affect My Asthma?

Breathing problems. Your rate of breathing will go up during the first trimester. This is a normal hormone-driven response in pregnancy. It is not usually a problem. The upward pressure of the growing fetus later in pregnancy can restrict the movement of your diaphragm, which may make you feel more breathless.

Gastroesophageal reflux disease (GERD) often occurs in pregnancy and gets worse during pregnancy if you already have it. GERD can cause stomach fluids to seep into the airways, producing inflammation and worsening asthma symptoms.

Sinusitis and nasal congestion are common as the hormones you produce during pregnancy can make the tiny blood vessels in your nose swell. Nasal congestion can increase mouth breathing, which in turn leads to airway drying and worse asthma symptoms.

Can Asthma Be a Problem During Labor?

Although you will breathe very fast and heavily at times during labor, asthma attacks are rare. The hormones that you release in labor are powerful muscle relaxants that help to protect you from breathing difficulties during labor. If needed, salbutamol can be used at all stages of pregnancy, including labor.

Should I Have the Flu Vaccine During Pregnancy?

Yes – it is recommended you have a flu vaccine if you have asthma. It can be administered at any stage of pregnancy.

For the Best Asthma Control

Keep taking your medications as prescribed.
Take an appointment to talk to your doctor or nurse about your asthma – they will be able to set your mind at rest if you have any concerns about taking asthma medication while you are pregnant.
Keep track of your symptoms. Use a peak flow meter to check your lung function regularly and keep your Action Plan up to date.
Don’t smoke. It isn’t good for your asthma, your general health or the health of your baby. It can also increase your risk of miscarriage and early labor.
Check your environment for potential triggers. Your immunity changes during pregnancy and irritants that did not affect you before could now cause you problems.

Please check out the previous and the next post of our series here:

Information based on Fast Facts for Patients and their Supporters: Asthma (Karger, 2020).