Asthma in Pregnancy
Section snippets
What is the Prevalence of Asthma During Pregnancy?
The burden of asthma in pregnancy is increasing worldwide,1, 2 with European estimates of at least 4% of women having asthma,3 and at least 8% of women in antenatal clinics in the United Kingdom having asthma.4 Increases in asthma prevalence have also been reported in the United States1 from around 3% to more than 8% since 1994.2 In Australia the prevalence of asthma in pregnancy is 12%.5 As the most common respiratory disorder to complicate pregnancy, asthma represents a significant public
Changes in asthma affect both mother and baby
In addition to the effect of pregnancy on asthma, it has been well described that asthma affects a wide range of pregnancy outcomes, related to both the mother (Table 1) and the neonate (Table 2). However, there is conflicting evidence in the literature regarding these effects, possibly due to sizeable variation in study design, sample size, and confounding factors in each published report. Many of the studies reporting increased risk of perinatal complications with asthma have been large
Do Women Stop Using Asthma Medications While Pregnant?
There is a large body of evidence indicating that pregnant women reduce their use of asthma medications during pregnancy, against the advice of current guidelines or their physician.28, 56, 128, 129, 130 A 2003 survey of more than 500 women of child-bearing age who had asthma indicated that 82% of those who used ICS treatment were concerned about the effects of this medication on the fetus.131 Despite also having concerns for their own health about the consequences of discontinuing medication,
Effective treatment and management of pregnant women with asthma
Asthma that is well controlled in pregnancy is less likely to result in adverse outcomes than poorly controlled asthma. Consequently, during pregnancy regular medical review and monitoring of asthma is recommended, and a multidisciplinary approach may be most effective. The goals of management in pregnant women are to minimize asthma symptoms and limitations, prevent exacerbations, and maintain near normal lung function with minimal medication use, thereby ensuring maternal quality of life and
Summary
Asthma is a highly prevalent medical problem during pregnancy. Exacerbations of asthma or poorly controlled disease can increase the risk of adverse perinatal outcomes, which may influence future health. Well-controlled asthma during pregnancy is not considered to be a significant risk to the baby, and regular monitoring of maternal asthma throughout pregnancy is recommended. By controlling asthma and preventing severe exacerbation, ICS may provide protection against adverse outcomes.
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Cited by (71)
Management of Chronic Asthma in Adults
2023, Primary Care - Clinics in Office PracticeGlobal Initiative for Asthma Strategy 2021. Executive Summary and Rationale for Key Changes
2022, Archivos de BronconeumologiaCitation Excerpt :Multimorbidity contributes to respiratory symptoms and impaired quality of life, and some comorbidities contribute to poor symptom control or exacerbations. Despite general concerns about medication use in pregnancy, the advantages of actively treating asthma in pregnancy to avoid exacerbations markedly outweigh any potential adverse effects of usual controller and reliever medications.54 For details of multidisciplinary assessment and management of asthma with comorbidities and in specific settings, see Chapter 3D in Ref. 4.
Global Initiative for Asthma Strategy 2021: Executive Summary and Rationale for Key Changes
2022, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Multimorbidity contributes to respiratory symptoms and impaired quality of life, and some comorbidities contribute to poor symptom control or exacerbations. Despite general concerns about medication use in pregnancy, the advantages of actively treating asthma in pregnancy to avoid exacerbations markedly outweigh any potential adverse effects of usual controller and reliever medications.54 For details of multidisciplinary assessment and management of asthma with comorbidities and in specific settings, see Chapter 3D in Reference 4.
Asthma Medication Use and Risk of Birth Defects: National Birth Defects Prevention Study, 1997-2011
2020, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Asthma affects 4% to 8% of pregnant women in the United States, and its prevalence is increasing.1-7
Japanese guidelines for adult asthma 2020
2020, Allergology InternationalCitation Excerpt :A recent study reported that premature delivery, low birth weight, and fetal malformations are more common among pregnant women with asthma than women with normal respiratory function, although the study primarily included women with poorly controlled disease.109 Careful management of asthma, regardless of severity, can reduce the risk of poor outcomes in the mother and the fetus.110 Pregnant women are generally quite concerned about the impact of pharmacotherapy on fetal development and delivery, and they prefer to avoid drugs and medications during pregnancy.
Funding support: V.E.M. is funded by an Australian Research Training Fellowship (Part-Time) from the National Health and Medical Research Council.
The authors have nothing to disclose.