wheeze in pregnancy

Overview

Wheeze is a high-pitched whistling sound you make when you breathe out. It happens when the breathing tubes in your lungs are narrowed or partly blocked. If you have wheeze during pregnancy, it means something is making your airways narrow — the most common reason is asthma, but it can also be caused by an infection or other lung condition. During pregnancy, changes in your body can affect your breathing, so it is important to have any wheeze checked by a healthcare professional.

Many pregnant people feel short of breath because the growing womb pushes up against the diaphragm. However, a true wheeze — a musical whistling sound — is less common and is not something to ignore.

Wheeze in pregnancy can affect anyone, but it is more likely if you already have asthma, allergies, or eczema. You may also develop wheeze during pregnancy if you have a chest infection or if you smoke. It can start for the first time during pregnancy too, so it does not only affect people with a history of breathing problems.

Symptoms

Common symptoms

• Whistling or squeaky sound when you breathe out
• Feeling short of breath or breathless
• Tight feeling in your chest
• Cough, especially at night or in the morning
• A faster rate of breathing than usual

Symptoms in children

• This article is about pregnancy. For children, wheezing can be a common symptom of viral infections or smaller airways. If you are concerned about a child who is wheezing, please seek medical advice.

Symptoms in older adults

• If you are older and pregnant, the symptoms of wheeze are the same. However, you may also have other health conditions that can affect your heart or lungs, so it is especially important to have any wheeze checked out early.

Causes

Main causes

• Asthma — the most common cause of wheeze in pregnancy
• Chest infections such as bronchitis or pneumonia
• Allergies to things like pollen, dust mites, or pets
• Changes in pregnancy hormones and increased pressure in the chest from the growing womb
• Acid reflux (heartburn) can sometimes irritate your airways and cause wheeze

Risk factors

• A history of asthma, eczema, or hay fever
• Smoking or being around secondhand smoke
• Being overweight or having obesity
• Having a cold or chest infection during pregnancy
• Being pregnant with multiples (twins or more), which increases pressure on the lungs

When to see a doctor

See a doctor urgently if:

• If you have a wheeze that is new, persistent, or getting worse
• If you feel short of breath at rest or cannot complete a sentence
• If you have a fever or cough up colored mucus
• If you have asthma and are using your rescue inhaler more than prescribed

Book a routine appointment if:

• If you are planning a pregnancy and have asthma, talk to your doctor about your asthma action plan
• If you have wheeze that comes and goes, make an appointment to discuss your symptoms
• If you have a pre-existing lung condition, have a review in early pregnancy to make sure your management plan is up to date

Diagnosis

A healthcare professional will ask about your symptoms and medical history, and listen to your chest with a stethoscope. They may also check your oxygen levels with a small sensor and ask you to blow into a device to measure air flow.

Tests that may be done

• A breathing test called spirometry, where you blow into a tube to measure how well your air moves out of your lungs
• A peak flow meter to measure how fast you can breathe out
• Blood tests to look for signs of infection or inflammation
• A chest X-ray may be done if the doctor needs a clearer picture — it is usually safe in pregnancy if the abdomen is protected, and only when the doctor thinks it is really necessary

What to expect at your appointment

The doctor will talk you through each test before it happens and explain why it is being done. If you have asthma, they may give you a written asthma action plan, which tells you which medication to take and when to seek help. They will also talk with you about how to keep your symptoms well controlled for the rest of your pregnancy.

Treatment

The main aim of treatment is to keep your airways open and make sure you and your baby are getting enough oxygen. Treatment is always planned carefully with your healthcare provider, and many breathing treatments are safe to use during pregnancy.

Self-care at home

• Rest when you need to, and try to keep calm — stress can make wheeze worse
• Drink plenty of water to keep mucus thin and easy to cough up
• Avoid smoke, strong smells, and allergens you know trigger you
• Use a humidifier or breathe steam from a bowl of warm water to soothe airways
• Sleep propped up on extra pillows if lying flat makes breathing harder

Medical treatments

Your doctor or asthma nurse may recommend inhaled treatments, which are usually given through a puffer or a nebuliser machine. They will explain which type is a reliever (used when you feel wheezy) and which is a preventer (used regularly to stop symptoms). If an infection is causing your wheeze, you may be prescribed antibiotics or other medicines that are safe in pregnancy. Always take the medication exactly as prescribed, and do not stop asthma medicines without speaking to your healthcare team first — poorly controlled asthma is a far greater risk to you and your baby than the medicines used to treat it.

When is surgery considered?

Surgery is not a treatment for wheeze in pregnancy. The focus is always on managing symptoms with medication and lifestyle measures.

Living with this condition

Living with wheeze in pregnancy means learning your triggers and staying on top of your symptoms. Keep your regular midwife and doctor appointments, and let your healthcare team know if anything changes. Carry your inhaler with you if you have one, and make sure friends or family know how to help if you get wheezy.

Lifestyle tips

• Do not smoke and avoid secondhand smoke
• If you have asthma, take your preventer inhaler as prescribed — even if you feel well
• Avoid known allergy triggers such as pollen, dust, or pet fur
• Get enough sleep, and use pillows to support your upper body if needed
• Practice slow, relaxed breathing exercises to help with breathlessness

Diet and exercise

A balanced diet with plenty of fruit, vegetables, and fluid is good for you and your baby. Gentle exercise such as walking, swimming, or pregnancy yoga can help strengthen your lungs and heart, but always check with your doctor or midwife before starting or continuing exercise. Stop and rest if you feel wheezy or breathless beyond a comfortable level.

Mental health and emotional wellbeing

Wheezing can feel frightening, especially when you are pregnant and worried about your baby. Anxiety can make it harder to breathe, creating a difficult cycle. It is completely normal to feel a mix of worry and frustration. Talk to your healthcare provider about how you are feeling — they can support you and, if needed, refer you for talking support. If you ever feel extremely hopeless or have thoughts of harming yourself or your baby, seek help immediately from your local emergency number or your mental health crisis team.

Prevention

You cannot always prevent wheeze, especially if you have asthma or get a chest infection. However, you can lower your risk by keeping asthma well controlled before and during pregnancy, avoiding smoking and smoke exposure, and reducing contact with things you are allergic to.

Vaccines

Vaccines can help prevent infections that may trigger wheeze. Talk to your doctor or midwife about vaccines that are recommended during pregnancy — such as the seasonal flu vaccine and the whooping cough (pertussis) vaccine. Keeping up to date with these can protect both you and your baby.

Screening programmes

If you have a history of asthma or other lung problems, your healthcare provider may check your lung function and oxygen levels during pregnancy. They will also monitor how your baby is growing to make sure everything is on track.

Complications

If left untreated

• Wheeze that is left untreated can lead to low oxygen levels in your blood, which can be harmful to you and your baby
• Asthma attacks can become more frequent or more severe
• A chest infection might spread and cause pneumonia
• Severe breathlessness can make it difficult to rest, eat, or function normally

Long-term outlook

The outlook is very good when wheeze is taken seriously and managed properly. Most pregnant people with asthma or a new wheeze go on to have a normal, healthy pregnancy and a healthy baby. Your healthcare team is there to help you keep symptoms under control, and they will work with you to adjust your treatment as your pregnancy changes. With the right plan and support, you can breathe and live well.

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