If you are pregnant, it is normal to feel a little short of breath at times. But if you have asthma, you may feel this shortness of breath a little more. Then, along with chest tightness, coughing, and a little fear of whether you and your baby are getting enough oxygen, right? Don't worry, let's talk about this in detail.
What is asthma during pregnancy?
Simply put, asthma is a long-term condition . This is when our airways, or breathing passages, become narrowed and blocked. This makes it difficult to breathe. During pregnancy, it is normal to experience some changes in your breathing. However, for someone with asthma, this can be more noticeable. Wheezing, a persistent cough, and a feeling of tightness in the chest can all come with it.
If you have asthma, it is very important to continue treatment to prevent flare-ups after pregnancy. If not managed properly, asthma can pose health risks to both you and your baby.
But remember this: If you follow your doctor's instructions carefully and take your medications on time, there is nothing to stop you from having a healthy pregnancy and giving birth to a healthy baby.
Does asthma get worse during pregnancy?
This can vary from person to person. For some people, asthma can actually get worse during pregnancy. Recent research suggests that about 40% of pregnant women experience an increase in asthma symptoms . But this mostly affects those who already have mild or moderate asthma before pregnancy. The other 60% either don't experience much of a change in their symptoms or actually experience a slight improvement in their asthma.
Here's what the researchers have found:
- If asthma worsens, it most often happens between 29 and 36 weeks of pregnancy .
- If asthma improves, it will happen gradually throughout the pregnancy.
- Asthma symptoms usually do not increase during labor and delivery .
- If your asthma symptoms change during pregnancy, they will usually return to normal within the first three months after delivery.
- If you experienced changes in asthma symptoms during a previous pregnancy, you are likely to experience similar changes in subsequent pregnancies.
Does asthma during pregnancy affect the baby?
Yes, asthma can pose health risks to your baby if it's not managed properly . The "unmanaged" part is the most important. Proper management of any medical condition during pregnancy is essential for both your health and your baby's. Uncontrolled asthma can reduce the amount of oxygen in your blood, which can cause your baby to not get enough oxygen. It also increases the risk of pregnancy complications.
Many times, complications arise for mothers with asthma during pregnancy because they don't understand how to properly manage their asthma during pregnancy. For example, some people think that asthma medication will harm the baby, so they stop taking it. But the truth is, not controlling their asthma can have a much worse effect on the baby than any side effect of any medication.
On the other hand, if you take the necessary steps to control your asthma (for example, taking your medication exactly as prescribed by your doctor), you are much more likely to have a healthy pregnancy and have a healthy baby.
How common is asthma among pregnant women?
In the United States, between 3% and 8% of pregnant women have asthma . It is the most common lung disease that doctors treat during pregnancy. The situation may be similar in Sri Lanka.
What are the symptoms of asthma during pregnancy?
Asthma symptoms during pregnancy are similar to those experienced by someone with asthma in general. You may have persistent symptoms, or you may have occasional asthma attacks. This means that you suddenly have difficulty breathing after being well.
The main symptoms are:
- Shortness of breath
- Cough (especially at night)
- Chest tightness, pain or pressure
- Wheezing - This happens when your airways become partially blocked.
The severity of these symptoms varies during pregnancy. Symptoms may improve, worsen, or remain unchanged.
What are the reasons for changes in asthma during pregnancy?
Pregnancy does not cause new asthma. However, your body changes during pregnancy, so you may experience your condition differently. Here are some changes that can affect your breathing:
- Uterine enlargement: As your baby grows, your uterus grows larger. This puts pressure on your diaphragm - the muscle that helps you breathe in and out of your lungs. This can make it harder for your diaphragm to move freely and take a full breath.
- Increased pregnancy hormones: During pregnancy, hormone levels change. This can cause your sinuses to become dry and swollen. This can cause a stuffy nose and make it difficult to breathe. In particular, the increase in the hormone progesterone can cause your breathing rate to increase.
- Increased heart rate: Your heart has to work harder to supply blood to both you and your baby. This extra effort can make you feel tired and short of breath.
If you have never been diagnosed with asthma before, and you suddenly have trouble breathing, it could be a normal breathing problem caused by these physical changes. It's not asthma. However, you may have previously had mild, undiagnosed asthma that's been triggered by changes during pregnancy.
Therefore, if you have any difficulty breathing, definitely see a doctor for advice .
Can asthma cause complications during pregnancy or childbirth?
Yes, uncontrolled asthma can increase the risk of some pregnancy complications . Also, people with severe asthma are more likely to develop complications than those with mild or moderate asthma. These complications can include:
- Preeclampsia: This is a serious condition associated with high blood pressure. It can affect your internal organs and pose serious risks to your baby.
- Premature birth: A baby born before 37 weeks. Such babies may have health problems due to developmental problems.
- Small gestational age or low birth weight: Smaller-than-normal babies may have health problems because their organ systems are not fully developed.
Whether your asthma is mild, moderate, or severe, having a treatment plan to prevent and control asthma flare-ups can help reduce the problems that can occur for both you and your baby.
What factors increase the risk of complications?
There are some factors that can worsen asthma during pregnancy and increase the risk of complications:
- Smoking.
- Not taking prescribed asthma medication or not following the treatment plan properly.
- Being overweight (BMI between 25 and 29) or obese (BMI 30 or higher).
How do doctors diagnose asthma during pregnancy?
In most cases, asthma is diagnosed before pregnancy. However, the process for diagnosing asthma during or after pregnancy is largely the same. Your doctor will only do tests that are safe for both you and your baby.
Diagnosis may include:
- Medical history: Details about your symptoms, such as when they occur most often.
- Physical examination.
- Spirometry test: This measures the speed and efficiency of airflow in your lungs.
Blood tests and other imaging procedures may be needed to determine whether the cause of your breathing difficulties is asthma or another medical condition.
How can I treat my asthma during pregnancy?
You should continue to follow your asthma management plan during pregnancy. This includes taking your prescribed asthma medications. Your doctor will confirm which medications are safe for both you and your baby.
This is what it means to manage your asthma well:
- Minimal (or no) symptom relief during the day.
- Being able to sleep well all night without asthma symptoms.
- Being able to perform daily tasks normally.
- It is very rare to need to use a reliever inhaler (rescue inhaler).
- Lung function is normal or near normal.
Make a treatment plan with your doctor.
Many doctors recommend that you have a preconception appointment before you start trying to have a baby. This is when you can make a plan for how to manage any medical conditions, such as asthma, during pregnancy, and what changes you need to make after you become pregnant.
After you become pregnant, talk to your doctor about a plan to monitor whether your asthma is being managed properly.
Monitor your condition.
This involves monitoring the health of both you and your baby. Your doctor will do the following:
- Checking your lungs and breathing: Your breathing may need to be checked regularly. You may also have a spirometry test to check your lung function. This is a test that is done in a doctor's office or hospital. You may also have a peak flow meter at home to measure your airflow daily.
- Checking the baby's organ function and development: You may need to have tests to check your baby's development. Ultrasounds are often done during pregnancy to check how your baby is growing. If you have moderate or severe asthma, or if your asthma is not well-controlled, you may need to have an ultrasound or a nonstress test to check your baby's heartbeat after 32 weeks of pregnancy.
Stay away from asthma triggers as much as possible.
You should be aware of the things that make your asthma worse, called "triggers," and avoid them as much as possible. Common triggers include:
- Tobacco smoke.
- Insect droppings (cockroaches, rats).
- Harsh chemical odors (like cleaning products).
- Strong scents (like perfume, cologne).
- House dust mites.
- Getting sick (cold, fever).
- Pet dander. The dogs in our homes are like cats.
- Stress.
- Pollen.
- Mold.
Take medication according to the treatment plan.
There are several types of asthma medications that are safe and effective. These include inhalers, oral medications (pills, and liquids). When prescribing asthma medication during pregnancy, your doctor will consider several factors:
- What medications have the longest track record of being safely used during pregnancy?
- What medications are most effective in controlling your asthma (depending on its severity)?
- What are the safest and most effective medications during each trimester of pregnancy?
Most people can continue to take their usual prescription medications during pregnancy, childbirth, and breastfeeding.
What is the outlook for people with asthma during pregnancy?
Compared to people without asthma, people with asthma have a slightly higher risk of pregnancy complications. But this risk is much higher if your asthma is not well-managed. This is why it is so important to follow your treatment plan throughout your pregnancy. Do not stop taking any medication unless your doctor tells you to.
How to reduce the risk of asthma-related complications during pregnancy?
The best way to reduce your risk is to follow your treatment plan exactly. This includes avoiding triggers and taking your medication on time. Many people stop taking their medications during pregnancy because they are afraid they will affect the baby.
Remember, poorly controlled asthma can have a much worse impact on your baby than the side effects of most common treatments. Also, your doctor will be monitoring you closely to make sure you are receiving the safest treatment possible.
What questions should I ask my doctor?
When you visit your doctor, don't hesitate to ask questions like these:
- What kind of doctors can help me manage my asthma? (e.g., allergist, immunologist )
- Will we have to change my medications?
- How often do I need to see a doctor to monitor my asthma?
- How can I monitor my asthma at home?
- What symptoms should I see a doctor for? Or should I go to an emergency room (ETU) ?
What is the "one-three rule" about asthma during pregnancy?
Previous research has suggested that changes in asthma symptoms during pregnancy can be understood in three ways:
- One in three people's symptoms improve.
- One in three people's symptoms worsen.
- One-third of the symptoms remain unchanged.
However, recent research shows that the number of people whose symptoms worsen is close to 40% .
Is it safe to take Albuterol during pregnancy?
Albuterol is considered one of the safest medications to use during pregnancy. Because this medication has been in use for a long time, many pregnant mothers who have used it to control their asthma have given birth to healthy babies.
However, the safest medication you can take is the one that best controls your asthma and protects you from the risk of pregnancy complications. Your doctor will recommend the medication that is best suited to your condition.
Can I get allergy shots while I'm pregnant?
Doctors don't start giving new allergy shots during pregnancy. But if you're already getting them, your doctor may continue giving them.
Can I get the flu shot during pregnancy?
Yes, you should definitely get the flu shot. The flu shot is recommended during any trimester of pregnancy. It can protect you from getting sick – a major cause of asthma exacerbations.
Finally, things to remember (Take-Home Message)
To have a successful pregnancy, it's important to take good care of yourself. This is true whether you have a long-term condition like asthma or not. Talk to your prenatal care provider about how asthma might affect your pregnancy and what changes you might need to make to your medications or your daily routine. Once you have a plan, stick to it. Taking steps to manage your asthma will increase your chances of having a healthy baby.
Don't be afraid to ask your doctor any questions you have, no matter how small. The health of both you and your baby is the most important thing!
` Asthma, pregnancy, breathing difficulties, asthma medication, baby's health, pregnancy complications, asthma control
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