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Asthma in Pregnancy

by Lara A. Friel, MD, PhD

The effect of pregnancy on asthma varies; deterioration is slightly more common than improvement, but most pregnant women do not have severe attacks.

The effect of asthma on pregnancy also varies, but severe, poorly controlled asthma increases risk of prematurity, preeclampsia, growth restriction, and maternal morbidity and mortality and requires cesarean delivery more often.


  • Inhaled bronchodilators and corticosteroids

  • For an acute exacerbation, addition of IV methylprednisolone, followed by oral prednisone

Pregnancy does not usually change treatment of asthma (see Asthma : Treatment; see also the National Heart, Lung, and Blood Institute practice guideline Managing asthma during pregnancy .) Women are taught strategies to help manage asthma, including how to minimize exposure to triggers and how to serially measure pulmonary function (usually with a handheld peak flow meter).

Inhaled bronchodilators and corticosteroids are first-line maintenance therapy. Budesonide (pregnancy category B), is the preferred inhaled corticosteroid. Theophylline is no longer recommended routinely during pregnancy.

For an acute exacerbation, in addition to bronchodilators, methylprednisolone 60 mg IV q 6 h for 24 to 48 h may be used, followed by oral prednisone in a tapering dose.

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