Asthma in Pregnancy

Asthma, one of the most common medical conditions affecting pregnant women, is a chronic respiratory condition caused by inflammation and swelling of the lower respiratory tract. When we breathe, air enters through our mouth or nose and travels through the respiratory tract to reach the lungs where gas exchange happens. However, in individuals with asthma, their narrowed airways mean airflow is restricted, resulting in breathing difficulties. 

If you are pregnant and your asthma is well-controlled, your risk of pregnancy complications is not significantly increased. However, pregnant women with uncontrolled asthma will have an increased risk of pregnancy complications. Uncontrolled asthma means that there is a reduction in the amount of oxygen in your blood, which leads to your baby not receiving enough oxygen.

How does asthma affect pregnancy?

When someone has an asthma attack, their airways are narrowed and hence less oxygen is present in their blood. This lack of oxygen means that the baby is not getting sufficient oxygen.

Uncontrolled asthma can have the following pregnancy complications:

• Premature birth
• Low birth weight of baby
• High blood pressure
• Preeclampsia 
• Stillbirth

If you have asthma, ensure that it is well-controlled so that you reduce your risk of pregnancy complications.

How is asthma controlled or monitored during pregnancy?

A study conducted in 2020 showed that during pregnancy, 1/3 of women reported improved asthma, 1/3 experienced exacerbated asthma, while the last 1/3 reported no change in asthma [1]. While pregnant with asthma, you will have a team of specialists to guide you through this journey with the main aim of keeping your asthma under control and giving you an uncomplicated pregnancy. 

Your team of specialists will work to achieve the following things:

• Good control of your asthma symptoms throughout the day
• Ensure good lung function
• Able to participate in normal day-to-day activities
• Prevent asthma attacks

Your lungs will also be carefully monitored during your antenatal care  and your asthma medication may have to be adjusted. Always keep your obstetrician updated about your symptoms – improving or worsening. 

There are also additional things you can practice by yourself to prevent your asthma from worsening, these are:

• Get the flu vaccine. Being infected with the flu can increase your risk of worsening asthma symptoms, so the flu vaccine will give you some protection.

Eat small meals and do not lie down immediately after eating to prevent heartburn and acid reflux. Heartburn and acid reflux increases when you are pregnant which can worsen your asthma symptoms.

What are the causes of asthma?

Despite the years of research, the exact cause of asthma is still unknown and poorly understood. 

There are, however, various triggers that are known to cause asthma attacks, these are:

Regardless of what triggers an asthma attack, it is the excessive reaction of the immune system that ultimately results in an asthma attack. Therefore, if you avoid the trigger of your asthma, you can reduce its rate and severity of occurrence. 

What are the symptoms of asthma?

The symptoms of asthma are as follows:

• Coughing: you might experience more coughing at night or in the morning, usually when the air is cooler.
• Shortness of breath: if your airways are narrowed, you will find it difficult to breathe, resulting in shortness of breath.
• Wheezing: a whistling sound that occurs when you breathe.
• Chest tightness: when your airways narrow and constrict, you might experience some chest tightness.

If you experience any of these symptoms while pregnant, inform your team of specialists (link to contact us) immediately so that early intervention and treatment can begin to prevent complications and ensure that your baby is receiving sufficient oxygen.

What are the risk factors that worsen your asthma during pregnancy?

There are certain factors that may worsen your asthma during pregnancy, these are:

• Allergens or irritants: your asthma may worsen during pregnancy if you have allergies.
• Infections: some respiratory infections like the flu can damage your lungs and exacerbate your asthma.
• Environmental factors: exposure to certain environmental factors may worsen your asthma symptoms.
• Exercise: strenuous exercise can worsen your asthma during pregnancy.

How is asthma treated during pregnancy?

Your asthma treatment must continue despite being pregnant as it is important to keep your asthma under control. The medicines used to treat asthma in general are safe in pregnancy. This includes reliever inhalers; preventer inhalers; long-acting and combined relievers; and if necessary steroid (prednisolone) tablets. It is important to discuss with your team of specialists on the best treatment for you during pregnancy.