Asthma and Pregnancy



Asthma can significantly affect pregnancy outcomes if not well-controlled. The National Asthma Education and Prevention Program (1) emphasizes that maintaining optimal control of asthma during pregnancy is important for the health and well-being of both the mother and her baby. Since asthma has a variable course during pregnancy, it is important to monitor closely to make adjustments in therapy. Pregnant women may be ambivalent about taking medications during pregnancy due to concerns about adverse effects on the fetus; however, the epidemiologic evidence is extremely strong in favor of using medications for asthma control.


Pregnant Woman Allergic Rhinitis Systemic Vascular Resistance Asthma Control Asthma Symptom 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    NAEPP expert panel report. Managing asthma during pregnancy: recommendations for pharmacologic treatment-2004 update. J Allergy Clin Immunol. 2005;115(1):34–46.CrossRefGoogle Scholar
  2. 2.
    Blais L, Forget A. Asthma exacerbations during the first trimester of pregnancy and the risk of congenital malformations among asthmatic women. J Allergy Clin Immunol. 2008;121(6):1379–84, 84 e1.Google Scholar
  3. 3.
    Kwon HL, Belanger K, Bracken MB. Asthma prevalence among pregnant and childbearing-aged women in the United States: estimates from national health surveys. Ann Epidemiol. 2003;13(5):317–24.PubMedCrossRefGoogle Scholar
  4. 4.
    Kwon HL, Triche EW, Belanger K, Bracken MB. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am. 2006;26(1):29–62.PubMedCrossRefGoogle Scholar
  5. 5.
    Grubbs S, Brundage SC. Preconception management of chronic diseases. J S  C Med Assoc. 2002;98(6):270–6.PubMedGoogle Scholar
  6. 6.
    D’Angelo D, Williams L, Morrow B, et al. Preconception and interconception health status of women who recently gave birth to a live-born infant--Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 reporting areas, 2004. MMWR Surveill Summ. 2007;56(10):1–35.PubMedGoogle Scholar
  7. 7.
    Cragan JD, Friedman JM, Holmes LB, et al. Ensuring the safe and effective use of medications during pregnancy: planning and prevention through preconception care. Matern Child Health J. 2006;10(5 Suppl):S129–35.PubMedCrossRefGoogle Scholar
  8. 8.
    Nettleman MD, Brewer J, Stafford M. Scheduling the first prenatal visit: office-based delays. Am J Obstet Gynecol. 2010;203(3):207 e1–3.Google Scholar
  9. 9.
    Dombrowski MP, Schatz M. ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists number 90, February 2008: asthma in pregnancy. Obstet Gynecol. 2008;111(2 Pt 1):457–64.PubMedGoogle Scholar
  10. 10.
    Hanania NA, Belfort MA. Acute asthma in pregnancy. Crit Care Med. 2005;33(10 Suppl):S319–24.PubMedCrossRefGoogle Scholar
  11. 11.
    Carroll KN, Griffin MR, Gebretsadik T, et al. Racial differences in asthma morbidity during pregnancy. Obstet Gynecol. 2005;106(1):66–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Chung KD, Demissie K, Rhoads GG. Asthma in pregnancy--its relationship with race, insurance, maternal education, and prenatal care utilization. J Natl Med Assoc. 2004;96(11):1414–21.PubMedGoogle Scholar
  13. 13.
    Nelson-Piercy C, Waldron M, Moore-Gillon J. Respiratory disease in pregnancy. Br J Hosp Med. 1994;51(8):398–401.PubMedGoogle Scholar
  14. 14.
    Hardy-Fairbanks AJ, Baker ER. Asthma in pregnancy: pathophysiology, diagnosis and management. Obstet Gynecol Clin North Am. 2010;37(2):159–72.PubMedCrossRefGoogle Scholar
  15. 15.
    Carlin A, Alfirevic Z. Physiological changes of pregnancy and monitoring. Best Pract Res Clin Obstet Gynaecol. 2008;22(5):801–23.PubMedCrossRefGoogle Scholar
  16. 16.
    Simon PM, Schwartzstein RM, Weiss JW, et al. Distinguishable types of dyspnea in patients with shortness of breath. Am Rev Respir Dis. 1990;142(5):1009–14.PubMedGoogle Scholar
  17. 17.
    Gilbert R, Auchincloss JH, Jr. Dyspnea of pregnancy. Clinical and physiological observations. Am J Med Sci. 1966;252(3):270–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Urbano FL. Review of the NAEPP 2007 Expert Panel Report (EPR-3) on Asthma Diagnosis and Treatment Guidelines. J Manag Care Pharm. 2008;14(1):41–9.PubMedGoogle Scholar
  19. 19.
    Bidad K, Heidarnazhad H, Pourpak Z, et al. Frequency of asthma as the cause of dyspnea in pregnancy. Int J Gynaecol Obstet. 2010;111:140–3.PubMedCrossRefGoogle Scholar
  20. 20.
    Schatz M, Dombrowski MP. Clinical practice. Asthma in pregnancy. N Engl J Med. 2009;360(18):1862–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Smith HE, Hogger C, Lallemant C, et al. Is structured allergy history sufficient when assessing patients with asthma and rhinitis in general practice? J Allergy Clin Immunol. 2009;123(3):646–50.PubMedCrossRefGoogle Scholar
  22. 22.
    Blais L, Kettani FZ, Elftouh N, Forget A. Effect of maternal asthma on the risk of specific congenital malformations: A population-based cohort study. Birth Defects Res A Clin Mol Teratol. 2010;88(4):216–22.PubMedGoogle Scholar
  23. 23.
    Murphy VE, Clifton VL, Gibson PG. Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax. 2006;61(2):169–76.PubMedCrossRefGoogle Scholar
  24. 24.
    Dombrowski MP. Asthma and pregnancy. Obstet Gynecol. 2006;108(3 Pt 1):667–81.PubMedCrossRefGoogle Scholar
  25. 25.
    Dombrowski MP, Schatz M. Asthma in pregnancy. Clin Obstet Gynecol. 2010;53(2):301–10.PubMedCrossRefGoogle Scholar
  26. 26.
    Bakhireva LN, Schatz M, Jones KL, Chambers CD. Asthma control during pregnancy and the risk of preterm delivery or impaired fetal growth. Ann Allergy Asthma Immunol. 2008;101(2):137–43.PubMedCrossRefGoogle Scholar
  27. 27.
    Wendel PJ, Ramin SM, Barnett-Hamm C, et al. Asthma treatment in pregnancy: a randomized controlled study. Am J Obstet Gynecol. 1996;175(1):150–4.PubMedCrossRefGoogle Scholar
  28. 28.
    Kircher S, Schatz M, Long L. Variables affecting asthma course during pregnancy. Ann Allergy Asthma Immunol. 2002;89(5):463–6.PubMedCrossRefGoogle Scholar
  29. 29.
    Schatz M, Dombrowski MP, Wise R, et al. Asthma morbidity during pregnancy can be predicted by severity classification. J Allergy Clin Immunol. 2003;112(2):283–8.PubMedCrossRefGoogle Scholar
  30. 30.
    Schatz M, Harden K, Forsythe A, et al. The course of asthma during pregnancy, post partum, and with successive pregnancies: a prospective analysis. J Allergy Clin Immunol. 1988;81(3):509–17.PubMedCrossRefGoogle Scholar
  31. 31.
    Kroegel C. [Global Initiative for Asthma Management and Prevention--GINA 2006]. Pneumologie. 2007;61(5):295–304.PubMedCrossRefGoogle Scholar
  32. 32.
    Belanger K, Hellenbrand ME, Holford TR, Bracken M. Effect of pregnancy on maternal asthma symptoms and medication use. Obstet Gynecol. 2010;115(3):559–67.PubMedCrossRefGoogle Scholar
  33. 33.
    Schatz M, Dombrowski MP, Wise R, et al. Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol. 2006;194(1):120–6.PubMedCrossRefGoogle Scholar
  34. 34.
    Murphy VE, Gibson PG, Talbot PI, et al. Asthma self-management skills and the use of asthma ­education during pregnancy. Eur Respir J. 2005;26(3):435–41.PubMedCrossRefGoogle Scholar
  35. 35.
    Cox L, Nelson H, Lockey R, et al. Allergen immunotherapy: a practice parameter third update. J Allergy Clin Immunol. 2011;127:S1–55.PubMedCrossRefGoogle Scholar
  36. 36.
    Blais L, Beauchesne MF, Rey E, et al. Use of inhaled corticosteroids during the first trimester of pregnancy and the risk of congenital malformations among women with asthma. Thorax. 2007;62(4):320–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Louik C, Schatz M, Hernandez-Diaz S, et al. Asthma in pregnancy and its pharmacologic treatment. Ann Allergy Asthma Immunol. 2010;105(2):110–7.PubMedCrossRefGoogle Scholar
  38. 38.
    Cydulka RK. Acute asthma during pregnancy. Immunol Allergy Clin North Am. 2006;26(1):103–17.PubMedCrossRefGoogle Scholar
  39. 39.
    Powrie RO, Larson L, Miller M. Managing asthma in expectant mothers. Treat Respir Med. 2006;5(1):1–10.PubMedCrossRefGoogle Scholar
  40. 40.
    Gluck JC, Gluck PA. The effect of pregnancy on the course of asthma. Immunol Allergy Clin North Am. 2006;26(1):63–80.PubMedCrossRefGoogle Scholar
  41. 41.
    Miller AC, Safi F, Hussain S, et al. Novel influenza A(H1N1) virus among gravid admissions. Arch Intern Med. 2010;170(10):868–73.PubMedCrossRefGoogle Scholar
  42. 42.
    Yates L, Pierce M, Stephens S, et al. Influenza A/H1N1v in pregnancy: an investigation of the characteristics and management of affected women and the relationship to pregnancy outcomes for mother and infant. Health Technol Assess. 2010;14(34):109–82.PubMedGoogle Scholar
  43. 43.
    Skret-Magierlo J, Florek A, Skret A, et al. Severe A/H1N1 influenza in four pregnant women in Podkarpacie Province of Poland. Ginekol Pol. 2010;81(3):227–31.PubMedGoogle Scholar
  44. 44.
    Farley MM. 2009 H1N1 influenza: a twenty-first century pandemic with roots in the early twentieth century. Am J Med Sci. 2010;340(3):202–8.PubMedCrossRefGoogle Scholar
  45. 45.
    Jain S, Kamimoto L, Bramley AM, et al. Hospitalized patients with 2009 H1N1 influenza in the United States, April-June 2009. N Engl J Med. 2009;361(20):1935–44.PubMedCrossRefGoogle Scholar
  46. 46.
    Einarson A, Riordan S. Smoking in pregnancy and lactation: a review of risks and cessation strategies. Eur J Clin Pharmacol. 2009;65(4):325–30.PubMedCrossRefGoogle Scholar
  47. 47.
    Newman RB, Momirova V, Dombrowski MP, et al. The effect of active and passive household cigarette smoke exposure on pregnant women with asthma. Chest. 2010;137(3):601–8.PubMedCrossRefGoogle Scholar
  48. 48.
    U.S. Preventive Services Task Force. Counseling and interventions to prevent tobacco use and tobacco-caused disease in adults and pregnant women: U.S. Preventive Services Task Force reaffirmation recommendation statement. Ann Intern Med. 2009;150(8):551–5.Google Scholar
  49. 49.
    Reichman NE, Nepomnyaschy L. Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years. Matern Child Health J. 2008;12(6):725–33.PubMedCrossRefGoogle Scholar
  50. 50.
    Martel MJ, Rey E, Beauchesne MF, et al. Control and severity of asthma during pregnancy are associated with asthma incidence in offspring: two-stage case-control study. Eur Respir J. 2009;34(3):579–87.PubMedCrossRefGoogle Scholar
  51. 51.
    Willers SM, Wijga AH, Brunekreef B, et al. Maternal food consumption during pregnancy and the longitudinal development of childhood asthma. Am J Respir Crit Care Med. 2008;178(2):124–31.PubMedCrossRefGoogle Scholar
  52. 52.
    Karmaus W, Dobai AL, Ogbuanu I, et al. Long-term effects of breastfeeding, maternal smoking during pregnancy, and recurrent lower respiratory tract infections on asthma in children. J Asthma. 2008;45(8):688–95.PubMedCrossRefGoogle Scholar
  53. 53.
    Midodzi WK, Rowe BH, Majaesic CM, et al. Early life factors associated with incidence of physician-diagnosed asthma in preschool children: results from the Canadian Early Childhood Development cohort study. J Asthma. 2010;47(1):7–13.PubMedCrossRefGoogle Scholar
  54. 54.
    Cookson H, Granell R, Joinson C, et al. Mothers’ anxiety during pregnancy is associated with asthma in their children. J Allergy Clin Immunol. 2009;123(4):847–53 e11.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal MedicineUniversity of California at DavisDavisUSA

Personalised recommendations