Asthma during pregnancy
Asthma is a lung disease that causes your airways to tighten up, making it hard for you to breathe. There’s no cure for asthma. Even if you have asthma and feel healthy, asthma flares (when symptoms become severe) can happen at any time.
Most people with asthma can keep the disease under control and avoid serious health problems. If you’re pregnant, it’s really important to work with your health care provider to manage your asthma and get medical care, if needed.
How does asthma affect pregnancy?
Asthma affects 4 to 8 out of 100 pregnant women (4 to 8 percent). If you keep your asthma under control, it probably won’t cause any problems during your pregnancy.
If you don’t control your asthma, you may be at risk for a serious health problem called preeclampsia. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache.
If you don’t control your asthma, your baby may not get enough oxygen. He may be at higher risk for health problems like:
Babies who are born too small and too soon are more likely to have newborn health problems. They can have trouble breathing and lasting disabilities, such as intellectual disabilities and cerebral palsy.
What are the signs and symptoms of asthma?
You may have one or more asthma symptoms. Signs and symptoms include:
- Tightness in the chest
- Constant cough (especially at night or in the early morning)
- Shortness of breath
- Wheezing (a whistling sound when you breathe)
What causes asthma symptoms?
One or more things can trigger your asthma. Some of the most common things that bring on asthma symptoms are:
About 7 out of 10 people with asthma (70 percent) have allergies. An allergy is a reaction to something you touch, eat or breathe in that makes you sneeze, get a rash or have trouble breathing.
Allergens are things that cause you to have allergy symptoms. Many also cause asthma symptoms. Common allergens are pollens, molds, animal dander (small flakes of dead skin), dust mites and cockroaches. Limit your contact with allergens. If you still have asthma symptoms, talk to your health care provider.
Your provider may recommend that you take an allergy medicine. If you’re already getting allergy shots, you can keep taking them during pregnancy. But if you aren’t getting allergy shots, don’t start taking them when you’re pregnant because you could have a serious allergic reaction called anaphylaxis.
Irritants are things in your environment that may hurt your lungs and trigger asthma symptoms, including air pollution, cigarette smoke and smoke from wood-burning stoves or fireplaces, cold air and strong smells, like paint or perfumes.
Infections like a cold, the flu or viral pneumonia, can trigger asthma symptoms in some people.
Exercise can cause asthma symptoms in some people. If your asthma is under control, you probably can exercise without any problems. But if exercising during pregnancy sets off your asthma, talk to your health care provider.
How is asthma diagnosed?
Asthma can be hard to diagnose. To find out if you have asthma, your health care provider takes your health history, does a physical exam and listens to your breathing.
You also may get a lung function test called spirometry. This is a test that checks how well your lungs work. During the test, you take a deep breath and exhale (blow) into a machine called a spirometer. This machine measures the amount of air you breathe in and out. It also measures how fast you can breathe. When you’re pregnant, normal changes in your body can make you short of breath. This test can help your provider know if shortness of breath is a common complication of pregnancy or if it’s caused by asthma.
How is asthma treated during pregnancy?
Your health care provider needs to monitor your lungs while you are pregnant so he can adjust your asthma medicines, if needed. Tell your provider if your symptoms improve or get worse. By limiting your contact with allergens and other asthma triggers, you may need to take less medicine to control your symptoms.
Is it safe to take asthma medicine during pregnancy?
Asthma symptoms that don’t stop or that get worse can be a risk to your and your baby. If you were taking asthma medicine before pregnancy, don’t stop taking it without talking to your provider first.
If you’re diagnosed with asthma during pregnancy, talk to your provider about the best way to treat or manage it.
If you’re already getting allergy shots, you can keep taking them during pregnancy. But if you aren’t getting allergy shots, don’t start taking them when you’re pregnant because you could have a serious allergic reaction called anaphylaxis.
Can asthma symptoms change during pregnancy?
Yes, asthma symptoms often change during pregnancy. Sometimes they get better and sometimes they get worse. We don’t really understand what causes these changes.
Getting the flu can set off serious asthma symptoms. Be sure to get a flu shot in October or November every year.
Heartburn also can make your symptoms worse. Here’s what you can do to help with heartburn symptoms:
- Sleep with your head up on a pillow (elevated).
- Eat smaller meals several times a day.
- Don’t eat within 2 hours of bedtime.
- Ask your provider about medicines you can take.
Do you need any special tests if you're pregnant and have asthma?
If your asthma is under control and mild, you may not need any special tests. If your asthma is not well controlled or if your asthma is moderate to severe, your provider may recommend repeated ultrasounds to check to make sure your baby’s growing normally. Ultrasound uses sound waves and a computer screen to make a picture of a baby in the womb. Your provider may start these at around 32 weeks of pregnancy.
Your provider also may recommend taking your baby’s heart rate with a fetal heart monitor. This allows him to check on your baby’s well-being.
Test results can alert your provider if you or your baby needs special care.
Can labor and birth set off asthma symptoms?
Only about 1 in 10 pregnant women with asthma (10 percent) have symptoms during labor and birth. Take your usual asthma medicines during labor and birth. If you still have asthma symptoms, your health care provider can help control them.
Are asthma medicines safe when you're breastfeeding?
Asthma medicines do get into your breast milk, but the amounts are very low and are safe for the baby. If you take high doses of certain asthma medicines, like theophylline, your baby may become irritable or have trouble sleeping. To help prevent this, take your asthma medicines 3 or 4 hours before the next feeding. Your provider and your baby’s provider can help you adjust your medicine schedule so you and your baby can get the health benefits of breastfeeding.
Last reviewed November 2011
Frequently Asked Questions
What is mononucleosis?
Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.
You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:
- Achy muscles
- Belly pain
- Fatigue (feeling tired all the time)
- Sore throat
- Swollen glands in your neck
If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.
There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.
Can Rh factor affect my baby?
The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.
If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.
If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.
I had a miscarriage. How long should I wait to try again?
Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.
Are gallstones common during pregnancy?
Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.