During pregnancy, mothers-to-be may feel uneasy taking medications.
However, if a pregnant woman has asthma, it is doubly important that her
symptoms be well-managed to increase both her health and her baby's health.
Uncontrolled asthma can be a threat to maternal well-being and fetal growth
and survival. The goals of asthma management and treatment during pregnancy
are the same as for other patients - to prevent hospitalization, emergency
room visits, work loss and chronic disability.
Pregnant women, like others with asthma, should avoid asthma triggers,
including specific allergens such as house dust mites and animal dander, and
irritants such as cigarette smoke. After discovering you are pregnant, see
your allergist/immunologist soon after to discuss the best way to manage
your asthma and what medications to take. He or she will be able to
prescribe effective asthma and allergy medications that are appropriate to
use during pregnancy, and will continue to work with you throughout your
pregnancy to ensure your treatment is effective, without side effects.
If you are pregnant and have asthma, you may have questions regarding the
best care for both your asthma symptoms and your baby. Following are some
common questions and answers to assist you.
Can women with asthma have safe, full-term pregnancies?
Studies show maternal asthma that is well-managed during pregnancy does not
increase the risk of maternal or infant complications. With appropriate
asthma management, you can have a healthy baby. Conversely, there is a
direct relationship between lower birth weight and uncontrolled asthma. So,
it benefits you and your baby to control asthma symptoms.
Why would uncontrolled asthma affect the fetus?
Uncontrolled asthma causes a decrease in the amount of oxygen in the
mother's blood. Since the fetus receives its oxygen from the mother's blood,
decreased oxygen in her blood can lead to decreased oxygen in the fetal
blood. This, in turn, can lead to impaired fetal growth and survival, since
a fetus requires a constant supply of oxygen for normal growth and
How do asthma medications affect the fetus?
Studies and observations of hundreds of pregnant women with asthma have
demonstrated that most inhaled asthma medications are appropriate for
patients to use while pregnant. The risks of uncontrolled asthma appear to
be greater than the risks of necessary asthma medications. However, oral
medications (pills) should be avoided unless necessary to control symptoms.
What effect does pregnancy have on asthma?
Pregnancy may affect the severity of asthma. One study showed that asthma
symptoms worsened in 35% of pregnant women, improved in 28% and remained the
same in 33% of the pregnant women. These changes in severity are another
reason to stay in close contact with your allergist/immunologist so he or
she can monitor your condition and alter your medications or dosages if
During what part of pregnancy will asthma change?
Asthma has a tendency to worsen during pregnancy in the late second and
early third trimesters; however, women may experience fewer symptoms during
the last four weeks of pregnancy. Troublesome asthma during labor and
delivery is extremely rare in women whose asthma has been adequately
controlled during pregnancy.
Why does asthma improve for some women during pregnancy?
The exact reason is unknown. Higher levels of cortisone in the body during
pregnancy may be an important cause of this improvement.
Why does asthma worsen for some women during pregnancy?
Again, the exact reasons are not known. Because the stomach area is
compacted during pregnancy, some women may experience gastroesophageal
reflux, a condition that causes heartburn and other symptoms. This reflux
can worsen asthma symptoms. Other conditions, such as sinus infections,
viral respiratory infections and increased stress, may also aggravate asthma
Can I continue to receive allergy shots during pregnancy?
Allergy shots do not have an adverse effect on pregnancy, so they can be
continued. As always, your allergist/immunologist will monitor your dose to
reduce the risk of an allergic reaction to the shots. These reactions are
rare; however, such a reaction could be harmful to the fetus. And, allergy
shot treatments should not be started for the first time during pregnancy.
Can women with asthma perform Lamaze?
Most women with asthma are able to perform Lamaze breathing techniques
Can I breast feed if I have asthma?
Breast feeding is a good way to increase your child's immunity, and is
encouraged. The transfer of most drugs into breast milk has not been
precisely evaluated; however, there appears to be no evidence that asthma
medications adversely affect nursing infants. (However, some infants may
become irritable from theophylline transferred by breast milk.) Also, if you
have allergy symptoms while nursing, it is appropriate to treat these as
well. Again, make sure to see your allergist/immunologist for the best
treatment of allergies and asthma while nursing.
Although these are common questions during pregnancy, each patient's
individual treatment varies. Managing asthma and avoiding asthma flare-ups
during pregnancy is important to the health of the mother and fetus. It is
best if women see their allergist/immunologist regularly during pregnancy so
that any worsening of asthma can be countered by appropriate changes in the
management program. Make sure to discuss any specific concerns with your
doctor to ensure the healthiest pregnancy - for your well-being and that of
Your allergist/immunologist can provide you with more information on
asthma and pregnancy.
Tips to Remember are created by the Public Education Committee
of the American Academy of Allergy, Asthma and Immunology. This brochure was
updated in 2003.
The content of this brochure is for informational purposes only. It is
not intended to replace evaluation by a physician. If you have questions or
medical concerns, please contact your allergist/immunologist.
American Academy of Allergy,
Asthma and Immunology
555 East Wells Street
Milwaukee, WI 53202-3823
AAAAI Physician Referral and
AAAAI Web site