Asthma in pregnancy

Overview

Asthma is a condition that makes the airways in your lungs narrow and swell, causing wheezing, coughing, chest tightness, and trouble breathing. During pregnancy, asthma can stay the same, get better, or get worse. For most women, it does not cause major problems if well managed.

Yes, asthma is one of the most common long-term conditions in women of childbearing age. Many pregnant women have asthma.

It affects women who already have asthma before pregnancy. Some women may develop asthma for the first time during pregnancy, though this is less common.

Symptoms

Common symptoms

• Wheezing (a whistling sound when you breathe)
• Shortness of breath
• Chest tightness or pain
• Coughing, especially at night or early morning

Causes

Main causes

• Asthma is caused by a combination of genes and environment. It is not fully understood.
• Pregnancy hormones and changes in your immune system can affect your asthma.

Risk factors

• Having asthma before pregnancy
• Being overweight or obese
• Smoking or exposure to second-hand smoke
• Having other allergies (like hay fever or eczema)

When to see a doctor

See a doctor urgently if:

• You have any of the emergency symptoms listed above
• Your asthma suddenly gets much worse and does not improve with your medicine

Book a routine appointment if:

• As soon as you find out you are pregnant, tell your GP or asthma nurse
• At each prenatal visit, talk about how your asthma is doing
• If you are using your rescue inhaler more often than usual

Diagnosis

Your doctor will ask about your symptoms, listen to your lungs, and may do breathing tests. If you already have asthma, your doctor will check how well it is controlled.

Tests that may be done

• Spirometry: you blow into a machine that measures how well your lungs work
• Peak flow meter: you blow into a small device to check your lung function daily
• FeNO test: you breathe into a machine that measures inflammation in your lungs

What to expect at your appointment

Your doctor will work with you to adjust your treatment plan for pregnancy. You may be asked to monitor your peak flow at home and have regular check-ups throughout your pregnancy.

Treatment

The goal of treatment is to keep your asthma well controlled so you and your baby get enough oxygen. This usually involves the same types of medicines you used before pregnancy, though doses may be adjusted.

Self-care at home

• Take your preventer medicine every day as prescribed, even if you feel fine
• Keep your rescue inhaler with you at all times
• Avoid known asthma triggers (like smoke, dust, pollen, or strong smells)
• Use a peak flow meter to track your breathing
• Stay active with gentle exercise like walking or pregnancy yoga, if your asthma is controlled

Medical treatments

Medical treatment includes preventer inhalers (typically containing corticosteroids) to reduce airway swelling, and reliever inhalers (bronchodilators) for quick relief of symptoms. Your doctor may also prescribe other types of inhalers or tablets if needed. All medicines are chosen to be safe in pregnancy.

Living with this condition

Managing asthma during pregnancy means taking your medicines regularly, avoiding triggers, and staying in contact with your healthcare team. Most women can have a normal pregnancy and delivery with well-controlled asthma.

Lifestyle tips

• Do not smoke and avoid places where people smoke
• Get the flu vaccine (it is safe in pregnancy and helps protect you)
• Manage allergies with antihistamines if approved by your doctor
• Learn relaxation techniques to reduce stress, which can trigger asthma

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. It is safe to exercise if your asthma is controlled. Gentle activities like walking, swimming, and prenatal yoga can help. Always have your rescue inhaler nearby.

Mental health and emotional wellbeing

It is normal to feel worried about your asthma and pregnancy at the same time. Anxiety can make breathing feel harder. Talk to your midwife or doctor about how you feel. They can help you find support.

Prevention

You cannot prevent asthma, but you can prevent asthma attacks during pregnancy by keeping your asthma well controlled with daily medicines and avoiding triggers.

Vaccines

The flu vaccine is recommended every year during pregnancy. It helps protect you from serious flu, which can trigger asthma attacks.

Screening programmes

Your doctor will check your asthma control at each prenatal visit. You may be asked to do regular peak flow monitoring at home.

Complications

If left untreated

• Poorly controlled asthma can reduce oxygen supply to your baby
• Increased risk of pre-eclampsia (high blood pressure in pregnancy)
• Higher chance of preterm birth (baby born too early)
• Low birth weight

Long-term outlook

With good medical care and by following your asthma plan, most women with asthma have healthy pregnancies and healthy babies. Work closely with your healthcare team to keep your asthma in check.

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