Asthma in pregnancy

Asthma is a chronic lung condition that can affect up to 10% of women during pregnancy. When effectively controlled, it presents little risk to your health and baby, however it’s important to know how to manage triggers and use medication safely. Uncontrolled asthma can cause harmful complications including high blood pressure, restricted fetal growth and premature birth.

Here we share everything you need to know about asthma and pregnancy including the precautions you can take to stay healthy.

Can asthma get worse with pregnancy?

Studies suggest that the severity of your asthma is linked to whether or not your symptoms will change during pregnancy.

Approximately a third of women with mild asthma will experience improved symptoms during pregnancy. But an equal number are likely to see worsened symptoms, particularly if they have severe forms of asthma. This negative impact typically happens during the third trimester, whilst a positive change can occur more gradually.

Research also shows that any changes experienced in a woman’s first pregnancy are likely to be repeated in future pregnancies. In most cases, after you have given birth, your symptoms are likely to return to how they were before you were pregnant.

Some women may experience asthma symptoms for the first time during pregnancy. This likely means you probably had mild asthma without realising and that symptoms were triggered by pregnancy hormones.

Asthma triggers and pregnancy

There are various things that can make asthma worse and trigger symptoms. These triggers may change during pregnancy:

• Allergies and hay fever. Pollen, dust mites and mould can cause sneezing, itchy eyes and a runny nose, making symptoms of asthma worse.
• Smoking. Smoking and exposure to second-hand smoke can both make asthma worse and cause harm to your unborn baby. Find out more about the risks of smoking and pregnancy and how to stop.
• Exercise. Exercising during pregnancy is encouraged to stay healthy, however some people find exercise can worsen symptoms.
• Cold and flu. The common cold or respiratory infections can worsen asthmatic symptoms.
• Animals. Having a pet or being around animals can trigger asthma either from their saliva, urine or fur.
• Hormonal changes. Pregnancy causes an influx of hormonal changes that can either positively or negatively impact asthma.

Asthma medications while pregnant

You shouldn’t stop taking asthma medication during pregnancy - most are safe to use and present little to no risk to you or your baby. Asthma treatments may include preventer and reliever inhalers, long-acting and combined relievers, and tablets. You should continue to take your prescribed asthma treatments throughout pregnancy.

If you are concerned about your medication during pregnancy, speak to your GP, asthma specialist or midwife either separately to or during your asthma review. You can get expert advice at any LloydsPharmacy including how to manage your asthma.

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Asthma and giving birth

It is important to tell your birth team and midwife about any asthma medication you are on, including steroid tablets, and discuss your birth plan before your due date. You should also ensure to discuss any allergies you have (such as latex) beforehand.

There is a very rare chance of having an asthma attack during labour. This is because the steroids your body produces during birth can also help to reduce inflammation in your airways. If you have any symptoms during labour, you can safely use your reliever inhaler as normal.

During birth you may be offered various types of pain relief such as gas and air, injections or an epidural. All of these options are safe for women with asthma.

Most women with asthma can have a vaginal birth and it is safe to do so if your asthma is well managed. If you are anxious about whether your asthma will affect you giving a vaginal birth, then talk to your midwife or doctor. If a Caesarean-section is considered, the anaesthetist will choose the most appropriate medicine for you. You will be able to use your inhaler during the operation if needed.

Can I breastfeed if I have asthma?

Breastfeeding is safe for women with asthma. Medication will not present any risk to your baby.. In fact, some research suggests that babies who are breastfed may be less likely to develop asthma. If you are unable to breastfeed, do not worry. If your baby develops asthma it is not because they weren’t breastfed. There are lots of reasons why asthma may be more likely for some babies, including a family history of asthma or allergies.

Tips to manage asthma during pregnancy

There are various things you can do to manage your asthma symptoms during pregnancy:

• Take your asthma medication. Continuing your prescribed medicines are safe to take during pregnancy and will present less risk to your baby than if you stop doing so and experience symptoms.
• Avoid triggers. During pregnancy, you can take some hay-fever medications but not others. You can also avoid things that trigger symptoms such as pet fur and mould.
• Manage stress. Practice mindfulness and relaxation techniques.
• Have the flu jab. This is safe to do during pregnancy and can also help to protect your baby from flu during the first trimester. It will help reduce risk of complications from having the flu including chest infections and pneumonia.
• Stop smoking. Avoid breathing second-hand smoke and give up smoking to avoid risk of symptoms and health complications.

In summary, if you have asthma, your symptoms may worsen, improve or remain unchanged during pregnancy. Make sure to tell your midwife and speak to your GP who will be able to advise on any changes to your medication if necessary and how you can manage your symptoms.

Find out more about how you can stay healthy by taking supplements during pregnancy and managing the flu whilst pregnant.

References

www.britishjournalofmidwifery.com/content/clinical-practice/asthma-in-pregnancy-physiology-management-and-recommendations-for-midwives
https://europeanlung.org/en/information-hub/factsheets/asthma-and-pregnancy
www.asthma.org.uk/advice/manage-your-asthma/pregnancy
www.nhs.uk/pregnancy/related-conditions/existing-health-conditions/asthma