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Effects of Asthma on Pregnancy - Associated Risks and Management

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Exacerbations of asthma during pregnancy are serious clinical issues resulting in maternal and fetal morbidity and mortality. Read below to know more.

Medically reviewed by

Dr. Richa Agarwal

Published At November 25, 2022
Reviewed AtMay 3, 2024

What Is Asthma?

Asthma is a medical condition that makes breathing difficult by causing the airways to constrict and tighten (bronchospasm). It is a chronic condition (long-lasting) that requires lifelong treatment or control. Women with asthma may encounter symptoms like coughing, wheezing, and difficulty breathing.

Symptoms of Asthma-

  • Chest tightness.

  • A persistent cough (especially at night or in the early morning).

  • Breathing difficulty.

  • Wheezing (a whistling sound during breathing).

Causes of Asthma-

  • Allergens.

  • Irritants.

  • Infection.

  • Exercise (rarely).

How does Asthma Affect Pregnancy?

For new parents, pregnancy is a beautiful and exciting time. However, pregnant women with asthma can be concerned about how their condition might harm the unborn child. Approximately one-third of asthmatic pregnant women will experience worsening asthma symptoms. The remaining third will not change. In the final third, their asthma symptoms will get better. Within three months of giving birth, most asthmatic women whose symptoms were altered during pregnancy will resume their pre-pregnancy state. It is crucial for both the mother and the unborn child to control any medical issues that may arise during pregnancy. For example, uncontrolled asthma may raise the risk of complications for the mother and the child.

What Are the Risks Associated With Asthma During Pregnancy?

Asthma is one of the most common medical issues that arise during pregnancy.

Asthma complications are possible and can include the following,

  • A slight increase in the chance of premature (preterm) labor and delivery.

  • Pre-eclampsia (high blood pressure during pregnancy).

  • Congenital anomalies.

  • Low birth weight (newborn babies weighing less than 5 pounds).

  • Neonatal hypoglycemia and seizures.

Uncontrolled asthma may lead to a decreased level of oxygen in the blood during pregnancy. Because of this, the newborn has less access to oxygen. Less oxygen may affect fetal development and survival. An infant is more at risk from poor asthma control than asthma treatment. Therefore, expecting a normal pregnancy should be possible with appropriate asthma control.

Pregnant women who have asthma may also develop the following morbidities,

  • Mechanical ventilation is required in cases of respiratory failure.

  • Barotrauma (harm to the body caused by variations in water or air pressure).

  • Consequences of using (parenteral) steroids.

How to Manage Asthma During Pregnancy?

The objectives of treating asthma during pregnancy are the same as those for treating asthma at any other point in life.

Asthma management entails:

  • Display little (or no) symptoms during the day.

  • Sleeping all night long without experiencing asthma symptoms.

  • Capable of carrying out daily activities.

  • An inhaler for pain relief is rarely necessary (also called a rescue inhaler).

  • Have lung function that is normal or near normal.

Before Pregnancy:

Preconception counseling is frequently advised by medical professionals while trying to get pregnant. This appointment with the doctor provides an opportunity to discuss any medical conditions women may have and general health with the clinician. During this meeting, many patients establish a game plan for how they will wish to address their medical issues, including asthma, during pregnancy. Pregnant women should not stop taking any drugs without first consulting a healthcare professional.

During Pregnancy:

Soon-to-be mother’s should stick to their asthma control regimen and treatment even during their pregnancy. However, before changing the drug regimen, it is necessary to consult with the doctor.

  • Avoiding triggers and irritants is one method to manage asthma while pregnant. One must prevent triggers and irritants like,

    • Pollen.

    • Dust mites.

    • Pet hair.

    • Smoke.

    • Pregnant women must avoid contact with people who have respiratory infections.

  • Pregnant women with asthma should enhance their avoidance strategies for maximum comfort with the least amount of medication.

  • For any pregnant woman, quitting smoking is essential. Smoking can worsen asthma symptoms and is bad for the developing fetus.

  • For good health, exercise is crucial. Swimming is a fantastic kind of exercise for those with asthma. Quick-relief medication taken 10 minutes to 15 minutes before suggested exercise may help pregnant women tolerate it.

After Pregnancy:

Although there are very few levels of asthma medications in breast milk, the babies are not harmed. However, the baby may become agitated or have problems falling asleep if the mother takes high doses of asthma medications, such as Theophylline. Taking the asthma medications three to four hours before the next feeding is advisable to help prevent this. For mother and baby to benefit from breastfeeding's health benefits, the doctor can help modify the medication plan.

How does Asthma Affect Labor and Birth?

When asthma is under control, labor and delivery are nearly never interrupted by asthma attacks. Additionally, most women with well-controlled asthma can labor painlessly while using breathing strategies.

Is It Safe to Use Asthma Medications and Inhalers During Pregnancy?

  • Inhaler- One of the most common worries is using an inhaler to manage asthma. The majority of inhalation medications are safe to use during pregnancy. Low doses of drugs are typically inhaled straight into the lungs by inhaler. A minimal amount of medicine is absorbed into the bloodstream by an inhaler. Before pregnancy, it is essential to schedule a consultation with the healthcare practitioner to discuss the best asthma management strategies and ensure that she takes the right medications.

  • Medications- Oral drugs (pills and liquids) are also safe to use in small doses during pregnancy. The medicines may be changed during pregnancy because asthma medications may be safer than others.

Asthma medications include,

  • Short-acting bronchodilators for inhalation.

  • Montelukast is an antileukotriene medication.

  • Certain corticosteroids for inhalation, such as Budesonide.

For pregnant women with asthma, long-acting beta-agonists are not recommended as the first line of treatment. But if the above medications are ineffective in controlling asthma, doctors may consider them. In addition, oral steroids like Prednisone may be required if asthma is extremely severe.

Is It Safe to Take Allergy Shots and Flu Shots During Pregnancy?

Flu Shot: People with asthma should get flu (influenza) shots. Pregnancy does not change that recommendation. The flu may be particularly severe in pregnant women.

Allergy Shot: If a pregnant woman is already receiving allergy shots (immunotherapy), she can typically keep doing so if there are no adverse side effects. To minimize the likelihood of a severe allergic reaction, an allergist may reduce the dosage of the allergy extract or maintain the same dosage. However, the doses should not be increased as it increases the chance of adverse reactions during pregnancy.

How to Prevent Passing On Asthma to the Baby?

The likelihood that a baby may acquire asthma is influenced by genetics. In other words, a baby is more likely to get asthma if their relatives have. But additionally, the environment also plays a crucial role. Maternal smoking is a significant prenatal risk factor for the emergence of asthma. It is crucial to stop smoking cigarettes.

The following other prenatal factors may also influence asthma development,

Conclusion:

The life of a pregnant woman can be exciting. It is also a time to look after oneself and ensure all medical concerns are controlled. If a woman has asthma, it is crucial to keep it under control during pregnancy. The best techniques to have a safe pregnancy while having asthma should be discussed with the doctor. Uncontrolled asthma may lead to preterm birth and low fetal birth weight. The prognosis of asthma in pregnancy is similar to asthma in other groups. Pregnant patients diagnosed with asthma should receive appropriate diagnosis and care. Pregnant patients should get the same care and management for asthma as non-pregnant patients.

Frequently Asked Questions

1.

What Are the Risk Factors in Pregnancy With Asthma?

Smoking, obesity, gestational diabetes, preeclampsia, and poorly managed asthma before conceiving are risk factors for pregnancy with asthma. These elements may aggravate asthma symptoms and increase the risk of problems for both the mother and the child. For these risks to be reduced, proper management and oversight are essential.

2.

Can Asthma Cause Any Birth Defects or Affect Pregnancy?

If the symptoms of asthma are controlled, it does not affect the pregnancy. Still, if asthma is not managed due to certain factors, it leads to decreased blood oxygen, which automatically means the child cannot get needed oxygen. Even with little complications, there are no birth defects due to asthma.

3.

Can Asthma Be Controlled During Pregnancy?

Yes, with the right therapy, asthma can be properly managed throughout pregnancy. Maintaining stable lung function can be achieved by closely coordinating medication adjustments with medical professionals, keeping an eye on asthma symptoms, and avoiding triggers. To reduce any possible hazards, it is crucial to make sure that both the mother and the infant receive the proper care.

4.

Is Natural Birth Possible With Asthma?

Yes, for women with well-controlled asthma, natural delivery is frequently feasible. A safe birth is facilitated by open communication between the medical staff and the pregnant mother. Monitoring and controlling asthma symptoms throughout pregnancy can help with a good natural delivery, but specific circumstances may differ, and the patient should always follow the doctor's advice.

5.

Can the Mother Transmit Asthma to the Child?

If a mother has asthma, there is a 25 percent chance that the child will also have asthma in the future. The risk increases with more percentile if both mother and father have asthma.

6.

Is Asthma During Pregnancy a Common Condition?

Around four to eight percent of pregnant women have asthma, and it is one of the most common conditions that affect the lungs during pregnancy. 

7.

Which Side to Sleep on During Pregnancy for Asthma?

Sleeping on the left side helps in reducing and managing the symptoms of asthma. The left side helps in keeping the airways open. Putting a pillow between the legs helps the spine get support and sleep better.

8.

How Can Asthma Be Cured Faster?

Some of the quick-relief inhalers that contain albuterol help in curing the asthma effects faster. They are also known as rescue inhalers as they open the airways quickly and help the mother breathe better. 

9.

How Asthma Is Detected Through a Blood Test?

A blood test is done to check the immune system and check the immunoglobulin E (IgE), white blood cells, and eosinophils levels. If their level is higher than normal, then it is a sign of severe asthma.
Dr. Richa Agarwal
Dr. Richa Agarwal

Obstetrics and Gynecology

Tags:

pregnancy complicationsasthma
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