Having a healthy, happy pregnancy is important, but if you are one of the 3% to 8% of women who have asthma during pregnancy, control of your condition is crucial.

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A hallmark of asthma is a flare-up leading to narrowing of the airways and making it difficult to breathe, with wheezing and coughing. If this happens during pregnancy, not only does the mother-to-be have breathing problems, but it can have a major effect on the baby as well, by reducing its oxygen supply.

That can lead to a list of complications, including:

  • Low birth weight.
  • Premature birth.
  • Need for cesarean delivery.

For some women, asthma can worsen during pregnancy. Even if your asthma is well-controlled prior to getting pregnant, it does not mean it will stay that way during pregnancy. For some women, there is no change in asthma while other women may even see their asthma improve.

Here are steps you can take – with guidance from your physician – to control your asthma and prevent flare-ups that are detrimental to you and your unborn child.

Avoid Known Asthma Triggers

To help prevent asthma symptoms, you should try to avoid your known asthma triggers.

According to the American College of Allergy, Asthma and Immunology, if you have pollen, mold, pet, and/or house dust mite allergy, you need to discuss ways to help reduce these triggers in your environment with your allergist. It goes without saying that you should not smoke and should avoid all second-hand smoke.

Asthma Medications During Pregnancy

You may need to have more frequent follow-ups with your allergist during pregnancy to make sure your asthma stays under control. You should not start or stop any of your asthma medications without first talking to your specialist.

There is always concern surrounding the use of any medications during pregnancy. The good news is that most asthma medications are safe for use during this time. Remember that there is more risk to you and your unborn baby from poor asthma control and flare-ups than from taking your asthma medications.

Medications that show the highest safety during pregnancy include:

  • Quick-relief medications: short-acting inhaled bronchodilators (albuterol, levalbuterol).
  • Long-term controller medications: some inhaled corticosteroids (budesonide, fluticasone) and leukotriene modifiers (montelukast).

Some asthma specialists will prescribe the use of inhaled corticosteroid/long-acting beta agonists (budesonide/formoterol) if they feel that the benefit for the severity of your asthma outweighs any risk.

Oral corticosteroids, like prednisone, may be used for a brief period if you have an acute asthma flare-up during pregnancy. These medications have been shown to reduce the risk of having to go to the emergency department or being hospitalized.

If you were on one of the newer asthma biologics like omalizumab prior to pregnancy, your allergist will probably continue it due to the severity of your asthma. Though there is not as much safety data with the asthma biologics during pregnancy as with the older medications, your asthma specialist may start one if your asthma becomes severe to minimize risk to you and the unborn baby.

Controlling Your Asthma While Pregnant

What about allergy immunotherapy shots, tablets or drops during pregnancy? If you are not on any of these treatments prior to getting pregnant, it is recommended not to start during this time. If you are already on one of these treatments, it is generally safe to continue, but this needs to be discussed with your physician. Many times, the dosage and frequency of treatment are changed during pregnancy.

You can control your asthma during pregnancy. Remember you are breathing for two during this special time.

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