Asthma is a chronic medical condition that is characterized by airway inflammation, hyperresponsiveness, and reversible airway obstruction. It is one of the most common medical conditions that can complicate a pregnancy and typically affects between 4% to 8% of the pregnant population. Poorly controlled asthma during pregnancy can lead to an increased incidence of premature birth, low birth weight, preeclampsia, and increased risk of infant death.
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Classification of Asthma Severity
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Medical Management
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Mild Intermittent Asthma- symptoms 2 days/week or less, nighttime awakening twice per month or less, no interference with normal activity, and FEV1 >80%
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No daily medications, albuterol as needed
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Mild Persistent Asthma- symptoms more than 2 days/week, but not daily; nighttime awakening more than twice per month; minor limitation of normal activity; FEV1>80%
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Preferred- Low-dose inhaled corticosteroid (i.e. *pulmicort) and albuterol as needed
Alternative- Cromolyn, leukotriene receptor antagonist (i.e. Singulair)
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Moderate Persistent Asthma- daily symptoms; nighttime awakening more than once per week; some limitation of normal activity; FEV1 60-80%
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Preferred- Low-dose inhaled corticosteroid (see above) and salmeterol (long acting beta 2 agonist) or medium-dose inhaled corticosteroid or (if needed) medium-dose inhaled corticosteroid and salmeterol.
Alternative- Low-dose or (if needed) medium-dose inhaled corticosteroid and leukotriene receptor antagonist (Singulair)
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Severe Persistent Asthma- symptoms throughout the day; nighttime awakening 4x/week or more; extremely limited normal activity; FEV1 <60%
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Preferred- High-dose inhaled corticosteroids and salmeterol . If needed add oral corticosteroid.
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*budesonide (pulmicort) is the preferred inhaled corticosteroid for use in pregnancy.
(4) Promptly address signs of worsening asthma to your healthcare provider.
If you want to know more about the anti-asthma drugs, please call us.
Don't play around with asthma! Remember, if you are having trouble breathing, your infant is too.
