The Pregnant Patient With Asthma: Assessment and Management

• Asthma is the most common chronic condition seen in pregnancy and affects as many as 8.8% of pregnant women. Asthma control worsens in 30%-40% of these women.
• Women who have asthma and become pregnant are at increased risk of preterm birth, intrauterine growth restriction, and other complications.
• Asthma in pregnancy is a condition often undertreated by general practitioners. Also, women with asthma who become pregnant often stop asthma medications or take less of their asthma medications, particularly inhaled corticosteroids.
• Clinicians should monitor the patient with asthma regularly with spirometry, peak expiratory flow rate (PEFR), and questionnaires, such as the Asthma Control Test (ACT).
• Medication regimens should be individualized to each expectant mother, and the clinician should titrate and add medications to optimally control the expectant mother’s asthma symptoms.
• Patient education regarding compliance with medication regimen and optimizing environments to avoid triggers should happen at every visit.

Asthma is the most common chronic condition seen in pregnant women. Women who have asthma and become pregnant are at increased risk of preterm birth and other complications, and the offspring of these women are at risk for congenital malformations at birth and respiratory diseases after the neonatal period. In this article we provide an overview of how asthma affects this population and discuss the assessment and management of the pregnant patient with asthma.