Pregnant Asthmatic Women Warned of Health Risks

“It’s important that women use their asthma medications throughout pregnancy and get regular checkups with their GP to ensure their asthma is under control.”

Dr Osei-Kumah has been awarded the inaugural Florey Early Career Northern Health Research Fellow in honour of the University’s most famous graduate Lord Howard Florey.

Outcomes and complications of asthma in pregnancy
Although women with mild asthma are unlikely to have problems, patients with severe asthma are at greater risk of deterioration. The deterioration risk is highest in the last portion of a pregnancy.

In fact, severe and/or poorly controlled asthma has been associated with numerous adverse perinatal outcomes, including the following:

- Preeclampsia
- Pregnancy-induced hypertension
- Uterine hemorrhage
- Preterm labor
- Premature birth
- Congenital anomalies
- Fetal growth restriction
- Low birth weight
- Neonatal hypoglycemia, seizures, tachypnea, and neonatal intensive care unit (ICU) admission

This risk of giving birth to a small or preterm infant appears to be small and may be minimized by good control of asthma. Studies have indicated that low-birth-weight infants are more common in women with daily symptoms or low expiratory flow than in women without asthma.

Asthma can also lead to the following morbidities in pregnant women:

- Respiratory failure and the need for mechanical ventilation
- Barotrauma
- Complications of (parenteral) steroid use

Death can also occur.

The Florey Fellowship will fund a two-year research project at the Lyell McEwin Hospital, helping pregnant women in the northern suburbs of Adelaide manage their asthma and reduce the health risks for their unborn child.

About 12% of the Australian population suffers from asthma, although this figure is higher in South Australia and also in low socio-economic areas due to a range of factors, including diet and lifestyle.

What are the effects of pregnancy on asthma?

When women with asthma become pregnant, one-third of the patients improve, one-third worsen, and the last third remain unchanged. Although studies vary widely on the overall effect of pregnancy on asthma, several reviews find the following similar trends:

- Women with severe asthma are more likely to worsen, while those with mild asthma are more likely to improve or remain unchanged.
- The change in the course of asthma in an individual woman during pregnancy tends to be similar on successive pregnancies.
- Asthma exacerbations are most likely to appear during the weeks 24 to 36 of gestation, with only occasional patients (10 percent or fewer) becoming symptomatic during labor and delivery.
- The changes in asthma noted during pregnancy usually return to pre-pregnancy status within three months of delivery.

Pregnancy may affect asthmatic patients in several ways. Hormonal changes that occur during pregnancy may affect both the nose and sinuses, as well as the lungs. An increase in the hormone estrogen contributes to congestion of the capillaries (tiny blood vessels) in the lining of the nose, which in turn leads to a “stuffy” nose in pregnancy (especially during the third trimester). A rise in progesterone causes increased respiratory drive, and a feeling of shortness of breath may be experienced as a result of this hormonal increase. These events may be confused with or add to allergic or other triggers of asthma. Spirometry and peak flow are measurements of airflow obstruction (a marker of asthma) that help your physician determine if asthma is the cause of shortness of breath during pregnancy.


Source: University of Adelaide

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