Asthma in pregnancy- Symptoms to discuss with your doctor

Pregnancy is a time of great change for women, and it can also be a time of concern for those who live with asthma. Affecting approximately 4-8% of moms-to-be, asthma is a chronic lung condition that can impact the health of the mother and developing fetus. For most women with well-controlled and mild asthma, pregnancy poses little risk for complications. However, for those who have moderate to severe asthma or poorly monitored and controlled asthma, pregnancy can pose several risks for both the mother and baby.  Any pregnant woman who has asthma needs to be aware of several symptoms that might signal a larger problem.

Asthma Complications – Symptoms and Conditions

Complications for pregnant women with asthma often increase in severity of symptoms during the last trimester, especially after the 28th week. It is difficult to reliably determine which patients with asthma will go on to have pregnancy related complications, and in fact up to one-third of expectant mothers actually see an improvement in their asthma symptoms. However, for the remaining two-thirds of women dealing with asthma symptoms, there might be early signs that something more significant is wrong.

Four Common Asthma Symptoms
Four of the most significant symptoms that pregnant women living with asthma need to monitor for include: wheezing, a feeling of breathlessness, a cough that occurs more at night and after physical exertion, and tightness in the chest. These symptoms are much the same as those that all asthma sufferers might experience, but for pregnant women it is dire that these symptoms be immediately addressed – if the woman is experiencing a shortness of breath there is a great likelihood that the fetus has reduced oxygen levels as well.

Asthma Triggers
These types of asthma symptoms might be caused by specific triggers, making it important for pregnant women to consult with their doctors to determine a plan to combat and avoid their own specific triggers that lead to asthma complications. Many individuals find that allergens affect their asthma severity, as well as irritants in the environment (cigarette smoke, pollution, perfumes, etc.). Pregnant women who are experiencing symptoms of allergic sensitivities or reactions need to diligently discuss this with their obstetrician.

Even though exercise is an important part of a healthy pregnancy, for some women with asthma this can cause asthma related symptoms to appear. If during exercise a pregnant women notices shortness of breath it is critical not to assume that it is the result of a good aerobic workout – it might just be the beginning of an asthma attack.

As pregnant women begin to move into the third trimester, it is not uncommon for them to experience more noticeable signs of gastroesophageal reflux disease, commonly referred to as GERD. This digestive disease is the cause of acid reflux and heartburn, but is also a condition that can worsen asthma symptoms. Controlling GERD by eating smaller meals, elevating the head during rest, and waiting two to three hours after eating before lying down can also help reduce asthma related issues.

Pregnancy Care for Women with Asthma

Even though many women who live with asthma go on to have uncomplicated pregnancies, there are reasons to be diligent with prenatal care. Asthma that is moderate to severe or inadequately controlled can lead to more severe complications.
Morning sickness can not only make women uncomfortable, but it can make managing asthma more challenging, and asthma can actually be a cause of prolonged or excessive nausea. Expectant mothers who are experiencing morning sickness that interferes with their daily routines should consult with their obstetricians and general practitioners to rule out any asthma related causes.

Poor fetal growth – Women with asthma complications during pregnancy should monitor fetal activity, especially after the 28th week, keeping track of fetal movements each day. Signs of reduced movement can signal an issue, and doctors can use ultrasound and fetal monitoring to check for fetal growth, heart rate, and amniotic fluid levels.

Asthma Medications
Fortunately, most asthma medications have been approved for use during pregnancy as safe for both women and developing babies. It is important for women to continue their asthma medication as prescribed, and discuss this with both your obstetrician and asthma specialist early during their pregnancy. Pregnant women can also use peak flow meters at home to determine if their breathing is on track, or if they need to seek further medical treatment.




Dr. Gareth Forde

About Dr. Gareth Forde

An obstetrician-gynecologist, a clinical professor, a researcher, and a father of five—and he delivered them all! He speaks and publishes extensively on maternal and child health issues, where he emphasizes the role of a healthy maternal lifestyle, good nutrition, and breastfeeding on infant development. He chose the field of obstetrics because it is a celebration of life, a happy and exciting profession. “Children are a blessing and they bring joy and laughter to the world,” he says. “I cherish my work, as a doctor and a dad.” The study of genetic imprinting is a major focus of both Dr. Forde’s research and medical practice. This looks at what happens in the womb, how the genes a baby inherits are expressed (turned on and off), and how this influences the child’s health after birth. “This field holds great promise, shedding light on many unsolved mysteries in health and disease from infancy to adulthood,” he adds. Dr. Forde grew up in London, England and Orlando, Florida. He received his medical degree from the University of Minnesota Medical School and is currently pursuing a fellowship in gynecologic oncology at the University of California, Irvine. Prior to this, he practiced with Grand Rapids Medical Education Partners, a consortium of Saint Mary’s Health Care, Spectrum Health, Grand Valley State University, and Michigan State University College of Human Medicine—where he was a clinical professor of obstetrics, gynecology, and reproductive biology. He also has a master’s in molecular and cellular biology from Florida Agricultural & Mechanical University; a Ph.D. in environmental science (computational chemistry) from Jackson State University; and a post-doctoral fellowship in biophysics from Mount Sinai School of Medicine, in New York.”