Becoming a new mother is an exciting time in your life. It is especially important that asthma is well-controlled when you are pregnant. Uncontrolled asthma increases the chance of complications for both the mother and the fetus. Low birth weight and premature delivery are examples of these problems.

The goals of asthma treatment during pregnancy are the same as any other time. Asthma control means that you:

  • Have minimal (or no) symptoms during the day
  • Sleep all night without asthma symptoms
  • Are able to perform normal activities
  • Rarely need to use your reliever inhaler
  • Have normal or near normal lung function

It is safer for your asthma to be treated with asthma medicines than for you to have an asthma episode.

Uncontrolled asthma may cause a decrease in the oxygen content in your blood, resulting in less oxygen available for your baby. This may cause impaired fetal growth and survival. Poor control of asthma is a greater risk to the baby than proper asthma treatment. With good asthma control, a normal pregnancy should be expected.

The following are some common questions and answers addressing concerns of pregnant asthmatics.

I use an inhaler to control my asthma. Will this harm my baby?

This is one of the most common concerns. Most inhaled medicines are safe for use during pregnancy. Inhaled medicines are low doses that are inhaled directly into the lungs, so there is very little, if any, absorbed into the mother's bloodstream. It is important to make an appointment with your asthma care provider to discuss your treatment options and make sure you are on the most appropriate medications.

Oral medications (pills and liquids) are usually avoided unless asthma cannot be controlled without them. Your doctor will determine this if and when necessary. In general, the same asthma treatment that is appropriate when you are pregnant is appropriate during labor and when you breastfeed your baby.

Can I take allergy shots and flu shots during my pregnancy? Are they safe?

You should tell your allergist if you are pregnant. Allergy shots are not started if a woman is pregnant. If you are already receiving allergy shots, your doctor will probably continue them. However, doses are usually not increased during pregnancy to help decrease the possibility of reactions. If you have moderate to severe asthma, a flu shot is generally a good idea. The flu shot should be given during the second and third trimesters only. Again, your doctor is the best person to decide how severe your asthma is and if you should receive a flu shot.

Will my pregnancy make my asthma worse?

There is no clear answer to this question. For some women, asthma gets worse. For some, it stays the same, and for some, it improves. If your asthma is severe, chances are it may become a little worse during your pregnancy. On the other hand, if you have had a previous pregnancy and your asthma did not get worse, chances are that it will not get worse during this pregnancy.

Asthma is almost never a reason to not get pregnant. However, if you have severe asthma, it is worth talking to your doctor before you get pregnant. Again, it is important to treat your asthma during pregnancy, and you should never start or stop taking a medicine without consulting your doctor first.

What should I do to control my asthma when I am pregnant?

During pregnancy, you will continue to follow your asthma control plan. Avoid your asthma triggers such as allergens (including pollens, house dust mites, pet dander) and irritants, especially tobacco smoke. Make sure you take your daily controller medications and always treat any asthma symptoms promptly.

In addition, following your Asthma Action Plan and maintaining a daily asthma diary will make it less likely that you will have serious problems. Communication with both your asthma care provider and obstetrician is essential.

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