Asthma during Pregnancy

Pregnancy

– is the state where women conceives and carries the fetus inside their womb for 9 months. During pregnancy, the woman may encounter several physiologic changes in their body including the respiratory system. 

Pregnant moms may feel tired, cranky and uncomfortable especially during the third trimester (7^th – 9^th month) and it is considered normal. However, there are cases wherein asthma attack occurs during the course of pregnancy and once it happens, that could be life-threatening.

Bronchial asthma is very common is U.S. and other urbanized countries. Pregnant women with asthma expect an untimely attack (exacerbation) anytime during pregnancy. These include the manifestations of dyspnea (difficulty of breathing), presence of wheezing when breathing and cough.

Furthermore, asthma attack during pregnancy can affect the well-being of the developing fetus. The oxygen supply of the fetus depends on the amount of oxygen inhaled by the mother. In this case, the fetus does not receive sufficient oxygen during asthma attack. This can lead to oxygen insufficiency and may cause several congenital problems in the later stage.

The most pressing issue concerning asthma during pregnancy is the hesitation of the pregnant mom to take medication. This is because most pregnant mothers fear that these medications might cause several fetal problems. It is considered as a misconception. 

We highly recommend pregnant moms with asthma to consult their doctor (obstetrician/gynecologist) regarding this matter because the risk of fetal anomalies caused by taking medications that controls asthma attack is rare.

Moreover, pregnant moms who failed to manage their asthma before or during pregnancy can increase the chance of having fetal problems. Aside from this, uncontrolled asthma during pregnancy can predispose the mother and developing fetus in the following complication:

Fetus (Fetal Problems)

• Preterm birth (premature birth – delivery of the baby before 37 weeks of gestation);

• Low birth weight (underweight – below 6 lbs.);

• Requires longer neonatal hospitalization after delivery of the baby.

Mother (Maternal Problems)

• Preeclampsia (without seizure) and Eclampsia (with seizure) – hypertension during pregnancy;

• Uterine bleeding

According to the U.S. Center for Disease Control (CDC), the prevalence rate of asthma in general population is about 4-5% while asthma during pregnancy ranges between 1% and 4%.

The mortality and morbidity rates related to asthma during pregnancy are comparable to general population statistics. Specifically, the mortality rate of asthma occurring during the course of pregnancy in U.S. is about 2.1 individuals out of 100,000 people.

The prognosis framework of this statistical report is categorized by the following:

• 30% of pregnant women with asthma may overcome the condition by experiencing improvements on their well-being;

• 33% of pregnant women with asthma may suffer from severe complications due to unmanaged condition; and

• 37% of pregnant women with asthma may have milder complications related to unmanaged condition.

If the asthma during pregnancy is unmanaged, the severity of the condition usually occurs at its peak level during the 24^th to 36^th week of gestation. This is because the growing fetus pushes the diaphragm which may provide lesser room for the mother’s lungs to expand. However, most pregnant women with asthma suffer from exacerbation anytime during the pregnancy.

Currently, there are reported cases of pregnant women suffered from asthma during the delivery of the baby. This can be life-threatening because medications that are used during and after the delivery of the neonate can worsen the condition.

- By Edterchelle Soriano