According to estimates, up to 8% of women suffer from asthma during pregnancy. Its control is especially important in the “blessed” period, because the health of the expectant mother and her child is at stake. What is the usual course of asthma during pregnancy and what is the specific treatment of it?
Asthma that is not under control – a danger for the pregnant woman and her baby
If asthma is well controlled, it does not pose a significant risk to the expectant mother and the developing fetus. However, poorly controlled asthma or an asthma attack can be a significant complication. During it, the amount of oxygen in the blood of the mother and eventually the fetus decreases. The consequence may be the slowing of its growth, or even the premature birth of a child with a low birth weight.
Severe asthma is more likely to worsen during pregnancy, while mild asthma is more likely to improve
During pregnancy, asthma worsens in about one third of women , improves in one third, and remains unchanged in the rest. And it is not unusual for asthma to manifest itself for the first time during pregnancy. Due to hormonal changes and the pressure of the growing uterus on the diaphragm, breathing difficulties are quite common during pregnancy, and therefore asthma is not always responsible for every shortness of breath.
Asthma that was severe and poorly controlled before conception is more likely to worsen during pregnancy. Mild asthma, on the other hand, often improves. A more severe course of the disease is more common in women with non-allergic type of asthma. Asthmatics usually have a similar course of the disease in subsequent pregnancies.
The peak of possible worsening of asthma is observed between the 26th and 36th week of pregnancy. It often improves in the last four weeks of pregnancy and is usually stabilized during delivery. Asthma usually returns to its original pre-pregnancy state within three months after giving birth.
Why can asthma get worse during pregnancy?
Worsening of asthma during pregnancy can be caused by so-called gastroesophageal reflux. Pregnant women complain the most about its manifestations (especially heartburn) in the 3rd trimester of pregnancy. As a result of hormonal changes (in particular increased levels of the female sex hormone progesterone), there is a backflow of acidic stomach contents into the esophagus.
Other causes of worsening asthma during pregnancy can be stress and inflammation of the sinuses.
Although there are not many pregnant women who smoke today, it is necessary to draw attention to one cause that can be easily influenced – smoking. In addition, active and passive increases the risk of developing this disease in the childhood of the child born. So if you want to do something for your baby, don’t smoke and breastfeed him as long as possible. Breastfeeding is encouraged in mothers with asthma. It reduces the child’s risk of developing atopy – a hereditary tendency to the development of allergic diseases, including asthma.
How is asthma treated during pregnancy?
A visit to an allergist or pulmonologist is appropriate even before the planned conception. During pregnancy, attend scheduled check-ups to the specialist as honestly as before and do not be afraid to contact him in case of any confusion. If you need to take relief medication more often than before, a treatment adjustment may be necessary.
Most asthma medications are relatively safe during pregnancy and breastfeeding. In general, the risk associated with their use is lower for both the expectant mother and the child than the risk of uncontrolled, inadequately treated asthma. Therefore, do not interrupt the treatment or change the dosage of the medication without consulting your doctor .
If your asthma is well controlled, you will probably continue with the same treatment regimen as before. Studies have shown safety in pregnancy for both inhaled beta2-mimetics and corticosteroids. They are advantageous due to their inhalation administration with less absorption into the bloodstream of the mother, and thus of the child. In the form of tablets, corticosteroids are used only in the treatment of severe asthma with a risk of life-threatening asthma attacks for both mother and child.
If you suffer from allergic asthma and you know its trigger (pollen, dust, animal fur, etc.), try to avoid it. This will not only reduce the risk of an asthma attack, but often also the need for relief treatment.
It is not recommended to start allergen immunotherapy during pregnancy due to a possible severe allergic reaction (anaphylaxis). Although it occurs rarely, it could have fatal consequences for both the mother and the fetus. If this treatment was started before pregnancy and was well tolerated, it is possible to continue it.