Frequently Asked Questions

Q - Can women with asthma have safe, full-term pregnancies?
A - Studies indicate that 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 is to both your and the baby’s benefit to control asthma symptoms.

Q - Why would uncontrolled asthma affect the fetus?
A - Uncontrolled asthma causes a decrease in the oxygen content of 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 development.

Q - How do asthma medications affect the fetus?
A - 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.

Q - What effect does pregnancy have on asthma?
A - Interestingly, pregnancy may affect the severity of asthma. One study demonstrated that asthma symptoms worsened in 35% of pregnant women, improved in 28% and remained the same in 33% of the pregnant women. These variations in severity are another reason to stay in close contact with your allergist so he or she can monitor your condition and alter your medications or dosages if necessary.

Q - During what part of pregnancy will asthma change?
A - 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.

Q - Why does asthma improve for some women during pregnancy?
A - The exact reason is unknown. Increased levels of cortisone in the body during pregnancy may be an important cause of this improvement.

Q - Why does asthma worsen for some women during pregnancy?
A - 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 during pregnancy.

Q - Can I continue to receive allergy shots during pregnancy?
A - Allergy shots do not have an adverse effect on pregnancy, so they can be continued. As always, your allergist will monitor your dose to lessen the risk of an allergic reaction to the shots. These reactions are rare; however, such a reaction could be harmful to the fetus. Allergy shot treatments should not be started for the first time during pregnancy.

Q - Can women with asthma perform Lamaze?
A - Most women with asthma are able to perform Lamaze breathing techniques without difficulty.

Q - Can I breast feed if I have asthma?
A - Breast feeding is a good way to increase your child’s immunity, and is encouraged. The transfer of drugs into breast milk has not been precisely evaluated; however, there appears to be no evidence that asthma medications such as theophylline, beta agonists or cromolyn sodium corticosteroids 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 use prescription drugs such as antihistamines and decongestants. Again, make sure to see your allergist for the best treatment of allergies and asthma during pregnancy and nursing.

While 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 allergists 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 baby.