Women who have asthma find that their disease gets worse when they get pregnant, especially in the last trimester. Asthma during pregnancy is such a important health problem that the National Institute of Health has put out tips for doctors and their patients.
Christine Habib is a first-time mother-to-be. She's also had asthma all her life. Because she had premature contractions at 28 weeks, she's been confined to her home until week 35.
Premature births are a risk for asthmatic women during pregnancy, and though Christine is not a fan of drugs, she worked out a pregnancy regimen with her doctor.
"I realized that the benefits of managing my asthma far outweighed any possible risks of taking medications during pregnancy," she said.
For women like Christine, the new recommendations are intended to guide doctors in the aggressive use of drugs to keep asthma under control and protect fetuses and their mothers.
"They need to take the right drug at the right time to address their asthma and control it properly," said Dr. Clifford Bassett, of NYU Medical Center.
There are drugs like inhaled sprays that open air passages for acute episodes, pills to reduce inflammation that constricts the airways and combination drugs to do both. Some drugs are approved for use in pregnant women. Others are not, but sometimes must be used to avoid a crisis.
When a pregnant woman has a bad asthma attack, her airways narrow. Less oxygen gets into the blood and that is not good for her or the baby.
Risks include premature birth, increased risk of infant death, preeclampsia, which is high blood pressure, and low birth weight.
Carine Kiss was aware of the risks. When she became pregnant, one of the first things she did was to work out a detailed plan to control her asthma.
"As you become more pregnant, the harder it is to be controlled, especially in the delivery room," she said. "So it was very important to me to develop a plan as soon as I found out i was pregnant."
Dr. Bassett says it's critical for doctors to control the triggers of asthma, such as allergy stimulants and irritants that can bring on asthma attacks. Educating patients in the correct use of inhalers and in other aspects of the disease is another key factor in asthma care.
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