Pregnancy and Asthma: How Does One Affect the Other?
When the woman with asthma becomes pregnant, the first thing both she and her doctor want to know is how the asthma will affect the pregnancy, labor and delivery.
"Studies have shown that the adage on prediction of complications still holds true", said Michael Schatz, an allergist and clinical professor at UC San Diego.
"About one-third of the women will get better, one-third will get worse, and one-third will stay the same," he said Saturday during a presentation at the American Academy of Allergy Asthma and Immunology conference in San Diego.
There are other factors, though, that help predict the course of the pregnancy in women with asthma. If this is not her first pregnancy, the asthma is likely to affect her current pregnancy in the same way it affected the previous pregnancy. In addition, if her asthma was severe before becoming pregnant, it's likely that her asthma will worsen during pregnancy.
"And women carrying females are more likely to get worse," Schatz said. But whatever the predictors, "we need to follow pregnant women with asthma closely."
There are conflicting studies on how asthma affects labor and delivery, but on the whole, women with asthma are at greater risk for complications, and the severity of the complications correlates with the severity of the asthma.
"About one in 10 women with asthma have problems during labor and delivery, but if the asthma is well controlled, there usually are no problems," Schatz said.
Mothers with asthma are generally concerned about the possibility of having children with asthma, and that does occur about 20 percent of the time (as compared with four to five percent in the general population). Breastfeeding and eliminating allergens, pets and smoking in the home can all help to aid in the prevention of asthma in newborns.
Taking asthma or allergy medications during pregnancy is always a concern to patients and their doctors, Schatz said. Unfortunately, there are few studies to prove whether these drugs are truly safe when taken during pregnancy. However, while there is evidence that suggests that many asthma medications are safe, some are probably safer than others. For instance, steroids that are inhaled are preferable to those taken orally. And while some of the older drugs have a longer track record of use, they also have more side effects than the newer drugs. This means that both patient and doctor must weigh the pros and cons of each, as well as factor in the severity of the asthma.
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