{"id":21984,"date":"2021-03-15T09:30:46","date_gmt":"2021-03-15T13:30:46","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=21984"},"modified":"2022-02-22T12:04:56","modified_gmt":"2022-02-22T17:04:56","slug":"asthma-and-pregnancy","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/asthma-and-pregnancy\/","title":{"rendered":"How to manage your asthma during pregnancy"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">When you\u2019re pregnant, it\u2019s natural to worry about, well\u2014everything. Is your baby developing normally? Are you getting enough nutrients to support two or more humans? Is worrying too much bad for your baby? And if you\u2019re one of the <\/span><span style=\"font-weight: 400;\">4% to 8% of pregnant women with asthma<\/span><span style=\"font-weight: 400;\">, you have to add breathing difficulties\u2014and the medications used to treat them\u2014to your list.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/conditions\/asthma-treatment-and-medications\"><span style=\"font-weight: 400;\">Asthma<\/span><\/a><span style=\"font-weight: 400;\"> is a chronic condition that causes airways in the lungs to narrow, swell, spasm, and produce extra mucus. This leads to chest tightness, coughing, wheezing, and other breathing problems, like shortness of breath. Should you expect worsening symptoms of asthma in pregnancy\u2014or complications?<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Asthma and pregnancy: What to expect when you\u2019re expecting<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Pregnant women with well-controlled asthma generally do fine during pregnancy, experts say.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cHaving asthma doesn\u2019t mean you\u2019re doomed to have pregnancy complications,\u201d notes <\/span><a href=\"https:\/\/health.tamu.edu\/experts\/hector-chapa.html\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Hector O. Chapa, MD<\/span><\/a><span style=\"font-weight: 400;\">, FACOG, clinical assistant professor of obstetrics &amp; gynecology at Texas A&amp;M College of Medicine. \u201cThis is a very treatable and manageable condition that shouldn\u2019t take away from the joy of pregnancy. Many women with asthma have healthy pregnancies.\u201d<\/span><\/p>\n<p><a href=\"https:\/\/www.nhlbi.nih.gov\/health-topics\/asthma\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">During pregnancy<\/span><\/a><span style=\"font-weight: 400;\">, you could see your asthma symptoms change due to the changes in your body. You may be at higher risk of asthma symptoms, so it\u2019s important to speak with your provider about keeping up with your long-term medicines such as inhaled corticosteroids.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Will asthma affect my pregnancy?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Uncontrolled asthma, on the other hand, can cause some serious pregnancy complications. Your asthma is considered \u201cuncontrolled\u201d if you need to use a rescue inhaler (to open up airways) two or more times a week; wake at night with breathing difficulties two or more times a month; or need to refill your prescription for said rescue medication two or more times a year. Some of those complications include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Preeclampsia:<\/b><span style=\"font-weight: 400;\"> This is a condition characterized by very high blood pressure, fluid retention, vision changes, and a severe headache. Researchers aren\u2019t exactly sure why asthma and preeclampsia seem to be related, but they suspect it may be due to the inflammation asthma causes. This inflammation can restrict blood flow to the placenta and the baby it\u2019s nourishing, driving blood pressure up. One <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/16572909\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">study<\/span><\/a><span style=\"font-weight: 400;\"> comparing pregnant women with severe asthma to those whose asthma was controlled found that the women with severe asthma were 30% more likely to develop preeclampsia than their controlled counterparts.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Small for gestational age (SGA):<\/b><span style=\"font-weight: 400;\"> An SGA newborn has a weight that is less than 10th percentile for age and gender. In one <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0954611110001277\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">study<\/span><\/a><span style=\"font-weight: 400;\">, pregnant women with severe or moderate asthma were 48% and 30% more likely to give birth to an SGA baby than women with mild asthma. Asthma can impact oxygen levels, which, in turn, can impact blood supply to a developing baby, affecting its growth.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Lower birth weight: <\/b><span style=\"font-weight: 400;\">A study published in the <\/span><a href=\"https:\/\/www.jacionline.org\/article\/S0091-6749(07)01039-1\/fulltext\" target=\"_blank\" rel=\"noopener\"><i><span style=\"font-weight: 400;\">Journal of Allergy and Clinical Immunology<\/span><\/i><\/a><span style=\"font-weight: 400;\"> found that women with asthma gave birth to infants who weighed 38 grams (about 1.3 ounces) less than babies delivered by women without asthma. Women with uncontrolled asthma had babies nearly 2 ounces lighter. Again oxygen\u2014or the lack of it\u2014seems to be a factor. \u201cPoor oxygenation of mom can lead to poor oxygenation of the placenta and growing baby,\u201d explains <\/span><a href=\"https:\/\/lluh.org\/provider\/figueroa-heather\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Heather Figueroa, MD<\/span><\/a><span style=\"font-weight: 400;\">, an OB-GYN at Loma Linda University Health.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">How to treat asthma during pregnancy<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The best way to avoid any negative outcomes of asthma and pregnancy is to make sure to prevent symptoms with lifestyle changes and medications.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Pregnancy-safe asthma medications<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Pregnant or not, don\u2019t stop taking any of your asthma medications without first talking to your healthcare provider. \u201cIn general, most asthma medications are safe to use in pregnancy,\u201d Dr. Chapa says. \u201cOB-GYN physicians agree that the risks of uncontrolled asthma are much greater than any theoretical risks of asthma medications. As always, medications that act more locally are preferred. This means that inhalers are the first line of treatment because they\u2019re less likely to pass to the fetus.\u201d In fact, it is better to use a daily controller medication (usually an inhaled steroid) than to have an asthma exacerbation, which may harm the baby and also expose both of you to more systemic medications.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the <\/span><a href=\"https:\/\/www.aaaai.org\/conditions-and-treatments\/library\/asthma-library\/asthma-and-pregnancy\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">American Academy of Allergy, Asthma, and Immunology<\/span><\/a><span style=\"font-weight: 400;\"> (AAAAI) and other experts, some of the safe-to-use asthma medications include:<\/span><\/p>\n<ul>\n<li><b>Inhaled corticosteroids<\/b><span style=\"font-weight: 400;\">, such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pulmicort-flexhaler\"><span style=\"font-weight: 400;\">Pulmicort Flex<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/budesonide\"><span style=\"font-weight: 400;\">budesonide<\/span><\/a><span style=\"font-weight: 400;\">): When used regularly over time, these medications can reduce inflammation in the airways and help keep serious asthma attacks at bay. \u201cThe use of a maintenance inhaler can reduce asthma exacerbations\u2014events that can put both mother and baby at risk of hypoxemia [low oxygen in the blood]\u2014and increase exposure to more medications that might not have otherwise been necessary,\u201d Dr. Figueroa notes.\u00a0<\/span><\/li>\n<li><b>Anti-leukotriene agents,<\/b><span style=\"font-weight: 400;\"> like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/singulair\"><span style=\"font-weight: 400;\">Singulair<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/montelukast-sodium\"><span style=\"font-weight: 400;\">montelukast<\/span><\/a><span style=\"font-weight: 400;\">) and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/accolate\"><span style=\"font-weight: 400;\">Accolate<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zafirlukast\"><span style=\"font-weight: 400;\">zafirlukast<\/span><\/a><span style=\"font-weight: 400;\">) are relatively safe during pregnancy; however, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zyflo\"><span style=\"font-weight: 400;\">Zyflo<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zileuton-er\"><span style=\"font-weight: 400;\">zileuton<\/span><\/a><span style=\"font-weight: 400;\">) is not. <\/span><span style=\"font-weight: 400;\">These medications work preventively to keep the airways open and reduce mucus in airways.<\/span><\/li>\n<li><b>Long-acting beta agonists<\/b><span style=\"font-weight: 400;\"> may be used in combination with inhaled corticosteroids as daily management medications.<\/span><\/li>\n<li><b>Short-acting Beta 2 agonists<\/b><span style=\"font-weight: 400;\">, such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/albuterol-sulfate\"><span style=\"font-weight: 400;\">albuterol<\/span><\/a><span style=\"font-weight: 400;\">: These are quick-acting drugs (also known as rescue medications), sometimes taken through an inhaler or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-a-nebulizer-machine\/\"><span style=\"font-weight: 400;\">nebulizer<\/span><\/a><span style=\"font-weight: 400;\"> (a machine that turns liquid medicine into a mist), to provide immediate relief to breathing problems.\u00a0<\/span><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/atrovent-hfa\"><b>Atrovent<\/b><\/a><b> (ipratropium):<\/b><span style=\"font-weight: 400;\"> \u201cThis is a specific type of medication called an anticholinergic,\u201d explains Dr. Chapa. \u201cIt\u2019s usually used as an inhaler and works similar to albuterol to relax airways.\u201d<\/span><\/li>\n<li><a href=\"https:\/\/www.singlecare.com\/prescription\/gastrocrom\"><b>Cromolyn sodium<\/b><\/a><b> inhaled (via a nebulizer):<\/b><span style=\"font-weight: 400;\"> This prevents the release of substances in the body that can cause airway inflammation. This is a prevention medication.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cIn cases of severe asthma attacks that are not alleviated by these options, physicians may<\/span><\/p>\n<p><span style=\"font-weight: 400;\">prescribe oral steroids [such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prednisone\"><span style=\"font-weight: 400;\">prednisone<\/span><\/a><span style=\"font-weight: 400;\">] for five to seven days to reduce airway inflammation,\u201d adds Dr. Chapa.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Lifestyle changes<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Medication isn\u2019t your only tool to help with troublesome asthma flares during pregnancy. To help ensure a healthier pregnancy:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Avoid any known <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/asthma-attack-triggers\/\"><b>asthma triggers<\/b><\/a><b>.<\/b><span style=\"font-weight: 400;\"> If dust, animal dander, cleaning products, chemicals, or cigarette smoke make your asthma worse, steer clear of them when you can.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Quit smoking or vaping, including non-tobacco substances such as marijuana.<\/b><span style=\"font-weight: 400;\"> It will improve asthma symptoms, and reduce risk of pregnancy complications due to asthma, nicotine exposure, or smoke.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Get a <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/flu-shot-while-pregnant\/\"><b>flu shot<\/b><\/a> <span style=\"font-weight: 400;\">if you\u2019ll be in your second or third trimester of pregnancy during flu season.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Get a<\/b> <b>COVID-19 vaccine<\/b><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stay in communication with your healthcare provider. <\/b><span style=\"font-weight: 400;\">That means keeping appointments, getting recommended tests, and taking your asthma medications as directed.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Stay healthy with regular exercise and good nutrition. <\/b><span style=\"font-weight: 400;\">Unhealthy weight gain exacerbates asthma. Good cardiovascular fitness promotes good lung health.<\/span><\/li>\n<\/ul>\n<h2><span style=\"font-weight: 400;\">Common asthma and pregnancy FAQs<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Asthma can be a serious health problem\u2014of course you have questions about how it might affect your pregnancy. Here, some common questions and their answers:<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Can pregnancy cause asthma?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">No, you won\u2019t develop pregnancy-induced asthma. But pregnancy can worsen what may have been mild (and easily overlooked) asthma symptoms you had pre-pregnancy. What\u2019s more, pregnancy itself can lead to some breathing problems that might be mistaken for asthma. \u201cA growing uterus can make a woman feel short of breath because it becomes harder to breathe deeply,\u201d Dr. Figueroa says. \u201cSinus passageways can also become a little more swollen in pregnancy, and thus can be more sensitive to allergies and feelings of congestion. And activity can make a woman feel more easily \u2018winded\u2019 or short of breath.\u201d While these things can make breathing harder, they usually don\u2019t cause wheezing, coughing, or chest tightness\u2014the hallmarks of asthma.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Can pregnant asthma patients have a normal delivery?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Yes. It\u2019s not very likely that you\u2019ll have an asthma attack during labor or delivery. For reasons that aren\u2019t entirely clear, the vast majority of women see an improvement in their asthma during labor and delivery. Only about 10% will have an exacerbation, which can be effectively treated, especially in a hospital setting.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Can I pass asthma on to my baby?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">You might. One of the factors that influence development of asthma is genetics. Also, women who experience pre-eclampsia are more likely to have a child with asthma.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">Are there any asthma medications that <\/span><i><span style=\"font-weight: 400;\">aren\u2019t<\/span><\/i><span style=\"font-weight: 400;\"> safe to use during pregnancy?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are a few. \u201cTheophylline [a drug that relaxes airways] is a particular medication that\u2019s considered controversial and contraindicated in pregnancy,\u201d says Dr. Chapa. \u201cSome animal studies that used this medication, at much higher doses than in humans, found a possible link between its use and certain birth defects. However, this has not been well-studied in pregnancy. For this reason, this medication is not advised.\u201d Good adherence to asthma prevention medication regimens will reduce the need for more harmful medications.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">As an asthmatic, will I need extra monitoring during pregnancy?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">That depends. If you have moderate-to-severe asthma, you may need to work more closely with your primary care provider or consult a pulmonologist as well as your obstetrician.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When you\u2019re pregnant, it\u2019s natural to worry about, well\u2014everything. Is your baby developing normally? Are you getting enough nutrients to support two or more humans? Is worrying too much bad for your baby? And if you\u2019re one of the 4% to 8% of pregnant women with asthma, you have to add breathing difficulties\u2014and the medications [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":22264,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[10965,8615],"coauthors":[10462],"class_list":["post-21984","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-asthma","tag-pregnancy","franchise-maternal-matters","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How to manage asthma in pregnancy<\/title>\n<meta name=\"description\" content=\"Fortunately, asthma can be controlled during pregnancy, labor, and delivery with these pregnancy-safe asthma medications 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