The relationship between asthma and pregnancy

The article was professionally consulted by Doctor Tran Thi Diem Trang - Respiratory Internal Medicine Doctor - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Asthma and pregnancy may interact through a variety of pathophysiological mechanisms. During pregnancy, 1/3 of asthma cases will be worse, 1/3 of asthma will be milder, and 1/3 of asthma will not change compared to pre-pregnancy.

Severe cases of asthma during pregnancy usually occur in the 6th, 7th month of pregnancy and will gradually ease in the last weeks. Acute asthma attacks rarely occur during labor. Asthma will adversely affect the health of both mother and child if not well controlled. The risk of complications may occur in the mother such as preeclampsia, abnormal vaginal bleeding or increased morning vomiting. Risks for the fetus include fetal growth retardation, preterm birth, low birth weight, or increased perinatal mortality.
Asthma medications are mostly safe during pregnancy, so the benefits of good asthma control with medication outweigh the side effects of medication for both mother and baby. Therefore, good asthma control in pregnant women is an achievable goal, and this has been shown to have many health benefits for both mother and child.

Most patients with bronchial asthma can have normal pregnancies and births like other healthy people. However, there are some cases of severe asthma, which is not well controlled, which can have negative effects on the fetus due to prolonged hypoxia and anemia.
Some studies in the last 2 decades have suggested that bronchial asthma in pregnant women has a risk of premature birth, low birth weight or some diseases (tachycardia, convulsions, hypoglycemia). ..) is higher than that of mothers without the disease. However, this risk is very small if asthma is stabilized, and it can be minimized by maintaining optimal disease control throughout pregnancy.

Asthma control treatment: For pregnant women, the goals, principles, and intensity of asthma treatment remain the same as in non-pregnant women. Regular visits to health facilities will help pregnant women with bronchial asthma have very favorable conditions to control the disease optimally.
Medications used in the treatment of asthma in pregnant women will not make any significant difference compared to those who are not pregnant. All medications commonly used in asthma, such as beta-agonists and inhaled corticosteroids, can be used safely during pregnancy.
Treatment of acute asthma attacks: As with control treatment, the treatment of acute asthma attacks in pregnant women will not be significantly different from those in nonpregnant women. Medications commonly used in the management of acute asthma attacks such as inhaled or inhaled beta2-agonist, Diaphyllin, intravenous corticosteroids, and oxygen can all be safely prescribed in pregnant women. Chest X-rays should be minimized to avoid exposing the fetus to ionizing radiation.
In summary, the treatment of asthma in pregnant women did not differ significantly from that in those who were not pregnant. The first priority of this treatment is to minimize the symptoms of the disease and all asthma medications are safe for pregnancy.
Finally, it is important to note that the risk to the fetus if asthma is not well controlled will be much higher than the toxicity of the drug. Therefore, patients with bronchial asthma during pregnancy should not stop or reduce the dose on their own without consulting a specialist.