Asthma in Pregnancy
Irina Petrache, MD
Catherine Sears, MD
William C. Shiel Jr., MD, FACP, FACR
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Asthma in Pregnancy Overview
Pregnancy is an exciting time in a woman's life. Changes in your body may be matched by changes in your emotions. You don't know what to expect from day to day. You may feel tired, uncomfortable, or cranky one day and energetic, healthy, and happy the next. The last thing you need is an asthma attack.
Asthma is one of the most common medical conditions in the U.S. and other developed countries. If you have asthma, you know what it means to have an exacerbation (attack). You may wheeze, cough, or have difficulty breathing. Remember that the fetus (developing baby) in your uterus (womb) depends on the air you breathe for its oxygen. When you have an asthma attack, the fetus may not get enough oxygen. This can put the fetus in great danger.
If you took medication for your asthma before you became pregnant, especially if your asthma was well controlled, you may be tempted to stop taking your medication out of fear that it might harm the fetus. That would be a mistake without the advice of your health-care provider. The risk to the fetus from most asthma medications is tiny compared to the risk from a severe asthma attack. Moreover, women with asthma that is uncontrolled are more likely to have complications during pregnancy. Their babies are more likely to be born preterm (premature), to be small or underweight at birth, and to require longer hospitalization after birth. Also, uncontrolled asthma can place your health at risk since you are more likely to experience preeclampsia or hypertension. Both of these conditions can place your baby at risk, as well. The more severe the asthma, the greater the risk to the fetus. In rare cases, the fetus can even die from oxygen deprivation.
How pregnancy may affect your asthma is unpredictable. About one-third of women with asthma experience improvement while they are pregnant, about one-third get worse, and the other third stay about the same. The milder your asthma was before pregnancy, and the better it is controlled during pregnancy, the better your chances of having few or no asthma symptoms during pregnancy.
If asthma control deteriorates during pregnancy, the symptoms tend to be at their worst during weeks 24-36 (months six through eight). Most women experience the same level of asthmatic symptoms in all their pregnancies. Although it is rare to have an asthma attack during delivery (10%), some of the medications used during or immediately after delivery can worsen asthma. Now, as throughout your pregnancy, it is important to let health-care professionals know that you have asthma. In most cases, symptoms return to "normal" within three months after delivery.
The important thing to remember is that your asthma can be controlled during pregnancy. If your asthma is controlled, you have just as much chance of a healthy, normal pregnancy and delivery as a woman who does not have asthma.
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