Pregnant women with asthma are just as likely to have healthy, normal babies as women without asthma, as long as their disease is kept under control.
That means getting regular monitoring and taking medication as needed.
The Working Group on Asthma and Pregnancy of the National Asthma Education and Prevention Program concluded that it is riskier to leave a woman's asthma uncontrolled than it is to use asthma medicines during pregnancy.
Concern about oxygen
A developing baby's oxygen supply is dependent on the mother's oxygen supply. When a pregnant woman's asthma is not controlled, she may not get enough oxygen. According to the American Academy of Allergy, Asthma and Immunology (AAAAI), this can result in the baby not getting enough oxygen either. A lack of oxygen can lead to a low-birth-weight baby, a preterm birth, or even death, according to The National Asthma Education and Prevention Program.
If you are pregnant and have asthma, you should be even more conscientious than usual about controlling your asthma, the AAAAI says. Try to avoid things that trigger your asthma, and take your asthma medications as needed to control the disease.
The National Asthma Education and Prevention Program (NAEPP) guidelines for managing asthma during pregnancy recommend a "stepwise" approach to asthma care. This is similar to that used in the NAEPP general asthma treatment guidelines for children and nonpregnant adults. In the stepwise approach, medication is based on asthma severity. Medication is stepped up when needed, and stepped down when possible.
Asthma severity worsens in approximately 35 percent of women who have asthma at the beginning of their pregnancy. No one can predict who will become worse. The guidelines recommend that pregnant women with persistent asthma have their asthma checked regularly by a health care provider, and that providers who offer obstetric care monitor asthma severity during prenatal visits.
The National Heart, Lung, and Blood Institute says these are key recommendations from the guidelines regarding asthma medications:
Albuterol, a short-acting inhaled beta-agonist, should be used as a quick-relief medication to treat asthma symptoms. Pregnant women with asthma should have this medication available at all times.
Women who have symptoms more than two days a week (but not daily) or more than two nights a month have mild persistent asthma and will generally need daily medication for long-term care of their asthma and to prevent its worsening. Inhaled corticosteroids are the preferred medication to control the underlying inflammation in pregnant women with persistent asthma. Alternative daily medications are leukotriene receptor antagonists, cromolyn, or theophylline.
For women whose persistent asthma is not well controlled on low doses of inhaled corticosteroids alone, the guidelines recommend either increasing the dose of inhaled corticosteroid or adding a long-acting beta-agonist.
Oral corticosteroids may be required for the treatment of severe asthma. The guidelines note that conflicting data regarding the safety of oral corticosteroids during pregnancy. Severe, uncontrolled asthma poses a definite risk to both the mother and the fetus, and use of oral corticosteroids may be warranted. Pregnant women should discuss the risks and benefits of oral corticosteroid treatment with their health care provider.
Pregnant women should also know and limit their exposure to asthma triggers, and get treatment for conditions that can worsen asthma control, such as allergic rhinitis, sinusitis, and gastroesophageal reflux disease.
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