Asthma in pregnancy

Asthma is a common condition affecting the lungs that causes difficulties breathing. While it often starts in childhood, it can affect people of any age. If you have asthma when you become pregnant, or develop asthma symptoms during pregnancy, you should inform your GP, asthma nurse or specialist. They will be able to advise you on the best way to control your symptoms during your pregnancy. Unfortunately, there is no way to predict what will happen to your asthma symptoms during pregnancy: some women will improve, some will stay the same, and some women, particularly those who had severe asthma before getting pregnant, may get worse.As long as your asthma is well managed, however, any risk to you and your baby is very small.

Asthma symptoms

The main symptoms of asthma are wheezing, breathlessness, coughing, and a feeling that there is a tight band around the chest. Sometimes, the symptoms of asthma can become worse, known as an ‘asthma attack’. As well as worsening of wheezing or breathlessness, you may be having an asthma attack if:

• You're so breathless that it is difficult to speak, eat or sleep
• Your reliever inhaler doesn’t help to reduce your symptoms
• Your breathing is getting faster or you can’t catch your breath
• Your peak flow rate has dropped below its normal level

If your symptoms are getting worse – for example, if you feel short of breath or tight in the chest, are using your reliever more often than usual, or are coughing and wheezing more – then you should contact your GP, asthma nurse or specialist. They will advise you whether your medication needs to be changed. If you are having an asthma attack and you don't have your reliever inhaler with you, or your reliever inhaler does not seem to be working after 10 puffs, you should call 999 immediately. An asthma attack is dangerous for you and your baby- so getting immediate treatment is very important, don’t delay!

Asthma treatments

Asthma cannot be cured, so the aim of treatment is to control symptoms, allowing people with asthma to live a normal life. Your practice nurse will work with you to develop a personal action plan for your asthma so that you know how to manage the symptoms at all times. The most common treatments for asthma are inhalers, allowing the medicine to be inhaled directly into the lungs where it is needed. If you are prescribed one or more inhalers, it is important to learn to use them correctly. Not using your inhalers properly will mean that the medicine does not go into the lungs. This means that it is less effective at controlling your symptoms and may lead to more side effects.

If you need to use your reliever more than three times each week, your GP or asthma nurse will recommend that you use a ‘preventer’ inhaler. The preventer is usually brown in colour and is taken daily to reduce inflammation in your airways. It is important to keep taking the preventer, even if your symptoms have disappeared, as without the medication they may come back. In some people, the preventer inhaler increases the risk of developing a fungal infection in the mouth which causes a sore tongue (oral thrush) and sometimes a sore throat or hoarse voice. To help prevent these side effects, you should always rinse your mouth out with water after using your preventer inhaler. Alternatively, take your inhaler immediately before you clean your teeth in the morning and at night. If symptoms persist your nurse may suggest you take your inhalers through a ‘spacer’ device which can help too.

If your preventer is not working effectively, your GP or nurse may decide that a combination inhaler containing both a preventer and reliever is better for you. As with a normal preventer inhaler, you should not stop taking the combination inhaler, even if you no longer have any symptoms. If your symptoms are not controlled by inhalers, then you may need tablet treatment as well. If you would like to know more about asthma medicines, the Asthma UK website has a lot of useful information opens in a new tab/window

Managing asthma during pregnancy

If you already have asthma when you become pregnant, you should not stop taking your medication. Instead, talk to your GP, asthma nurse or specialist, who will be able to advise you about how to manage your asthma during pregnancy. Most asthma medications are safe for pregnant women and will not harm your baby. If your asthma symptoms are stable, there is usually no reason for you to change your treatment at all during pregnancy. Stopping your medication, however, is likely to make your symptoms worse. This can increase your risk of an asthma attack which can be life threatening for you and your baby.

Some women who do not have asthma when they become pregnant can develop asthma as a result of pregnancyyou develop symptoms of asthma while you are pregnant, such as wheezing or shortness of breath, you should see your GP. They will usually be able to determine whether or not you have asthma based on your symptoms and some simple tests.If you do have asthma, they will advise on the best treatment for your symptoms, and will work with you to create a personal action plan to help manage your condition during pregnancy and after the birth.

As well as taking your medication, there are other things you can do while you are pregnant to help to manage your asthma. For example, if you know that you are allergic to certain things, such as cats or dogs, then try to avoid contact with them during your pregnancy. You should also try to exercise and eat a healthy diet when pregnant. If you smoke, you should try to give up as soon as possible, and avoid second-hand smoke (‘passive smoking’) wherever possible. If you also suffer from hay fever, talk to your GP or pharmacist about medications (‘antihistamines’) that are safe to use during pregnancy, and avoid activities such as mowing the lawn that can increase your risk of hay fever. As pregnancy and asthma are both associated with more serious complications in patients who get influenza (‘flu’), it is highly recommended that you have the annual flu vaccine, which is safe for pregnant women at any stage of their pregnancy.

Will asthma affect the birth?

Having asthma is unlikely to affect your labour and the birth of your baby.All forms of pain relief during labour are safe for pregnant women, and you can use your reliever inhaler normally during labour if you need to. Asthma attacks are very rare during labour, and it is thought that this is because the steroids your body produces normally during labour help to reduce inflammation. If you are anxious about having asthma during labour, talk to your GP, asthma nurse or midwife before your due date. You may also want to include your plan for managing your asthma on your birth plan.

Will my baby have asthma?

The exact cause of asthma is largely unknown. Just because you have asthma during your pregnancy, it does not mean that your baby will. Asthma does run in families, however. If you and the baby’s father both have asthma, your baby will have an increased risk of developing asthma as well. Premature babies are also at higher risk of asthma, as are those who are exposed to cigarette smoke. If you have any concerns about your baby’s breathing, see your GP immediately.