Asthma and Pregnancy

Asthma is considered one of the most common health conditions that can complicate pregnancy. The Women's Health NetWork has provided resources and information that shares the risks and potential treatment options for pregnant women.

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  1. Asthma is one of the most common chronic diseases in pregnancy.
  2. The course of asthma during pregnancy may vary by women. In general one-third do better, one-third get worse, and one-third stay the same.
  3. In population-based, retrospective studies,asthma is associated with worse perinatal outcomes including pre-eclampsia and small birth weights. Mendola paper and Murphy et al, BJOG 2013
  4. Asthma exacerbations and asthma severity are associated with worse perinatal outcomes. Namazy et al, 2013
  5. In fact, uncontrolled asthma during pregnancy is also associated with an increased risk of maternal depression.
  6. There is some evidence that use of oral corticosteroids to treat asthma during pregnancy may be associated with preterm birth or a small increase in congenital anomalies, however this is retrospective data and may be confounded by asthma severity as well as other factors. Bjorn et al, basic and clinical pharmacology, 2015
  7. There is recent data that suggests a possible increase in cleft palate and gastroschisis associated with long-acting beta-agonist use in the first trimester, however this is retrospective registry data, and the overall increase risk remains extremely small.
  8. Exposure to H1 antihistamines appears to be safe in pregnancy.
    A review of H1 antihistamines (commonly used in asthma) during pregnancy.
  9. In very extreme cases, extracorporeal membrane oxygenation (ECMO) has been used to successfully treat pregnant women with asthma occurring during pregnancy.
  10. The guidelines from the Global Initiative for asthma clearly state that standard therapies for asthma are safe during pregnancy.
  11. Despite this data, there remains reluctance on the part of providers and patients to continue treatment during pregnancy. Enriquez et al, 2006.
  12. There is emerging evidence that some supplements may reduce the risk of wheeze in offspring at risk for developing asthma. However, all pregnant women should consult with their provider before initiating any supplements.
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