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. “All that wheezes is not asthma” – a case of peripartum cardiomyopathy in a pregnant woman with a history of asthma, admitted with acute onset of dyspnea.

  3. Severe asthma in pregnancy may be complicated by other conditions. This report describes a case of severe starvation ketosis (a known potential issue in pregnancy), presenting as a severe metabolic acidosis complicating a life-threatening asthma attack.
  4. The risk of a variety of obstetric complications is significantly increased in women with asthma, including preeclampsia, gestational diabetes, placental abruption, and preterm birth (often medically indicated, rather than spontaneous) based on results of a retrospective study of 223,000 US women over 7 years.
  5. The placenta appears to adapt to the presence of chronic asthma in a sex-specific manner. Data suggest that the male fetus may be at risk for worse outcomes from both chronic asthma as well as acute inflammatory events such as those associated with an asthma exacerbation. There are also sex-specific alterations in placental gene expression in the presence of maternal asthma.
  6. A third of adults with asthma may be misdiagnosed. This may be true in reproductive age women as well and may impact management in pregnancy.
  7. The gender of the fetus may affect pregnancy outcomes:
    “Fetal sex is associated with maternal stimulated cytokine production, but not serum cytokine levels, in human pregnancy” and implies that maternal asthma is exacerbated among women carrying female versus male fetuses.
  8. Impact of maternal use of asthma-controller therapy on perinatal outcomes.
  9. Some evidence from retrospective case studies that beta-agonists in the first trimester may be associated with increased risk of gastroschisis and cleft palate, and LABA with renal dysplasia:
  10. Maternal depression with an increased incidence uncontrolled asthma during pregnancy:
  11. Conventional Treatment:
  12. Fish oil supplementation may reduce the risk of wheeze in offspring:
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