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.
Pregnancy does not usually change treatment of asthma (see 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 corticosteroid inhalers 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.
Last full review/revision June 2013 by Lara A. Friel, MD, PhD
Content last modified October 2013