Allergy & Asthma Network Mothers of Asthmatics (AANMA)

1. I have asthma and in the past have received the flu shot each year. I just found out I am pregnant. Should I still get the flu shot?
The Centers for Disease Control and Prevention (CDC) 2008-2009 Advisory Committee on Immunization Practices (ACIP) says pregnant women are at risk for influenza complications and recommends all women who are pregnant or will be pregnant during influenza season be vaccinated. The American College of Obstetricians and Gynecologists and the American Academy of Family Physicians also have recommended routine vaccination of all pregnant women. The nasal-spray vaccine (LAIV, or live attenuated influenza vaccine) is not licensed for use in pregnant women, but CDC says pregnant women do not need to avoid contact with persons recently vaccinated with LAIV. Discuss any concerns about the flu shot with your physician prior to vaccination.

2. I have asthma and am thinking about getting pregnant, but am worried how being pregnant will affect my asthma.
Studies have shown that one-third of pregnant women with asthma report their symptoms got worse during their pregnancy, one-third say they stayed the same, and one-third say their symptoms actually improved. If asthma worsens during pregnancy, it tends to occur in the late second and early third trimesters. Women may then experience fewer symptoms during the last four weeks of pregnancy. Difficulties with asthma during labor and delivery are very rare for those whose asthma has been well controlled throughout the pregnancy.

3. I have asthma and am finding that I have been waking up the last several nights needing to use my inhaler. I am pregnant and am very worried that this might be affecting my baby. What should I do?
When it is well managed during pregnancy, asthma should not increase the risk of complications to your unborn baby. If you are waking up at night and need to use your inhaler, it may be an indication that your asthma is not under optimum control. It is vital that you work with both your asthma physician and your obstetrician to optimize your asthma care. Report any asthma symptoms you may be experiencing so that your physicians can take appropriate action.

Poorly controlled asthma may cause a decrease in the oxygen level of the mother, which in turn may cause a decrease in the oxygen level of the fetus. A fetus needs oxygen for normal growth and development, so decreased amounts of oxygen can lead to impaired fetal growth and survival.

4. I am excited about my pregnancy, but worried because I am on several different medicines for my asthma. Are these medicines safe for my baby?
The U.S. Food and Drug Administration (FDA) classifies medications for use during pregnancy in categories A-D and X. Because many asthma medications can have effects on pregnancy, most of them fall into category C which means they can be prescribed by the physician when the benefits for using them outweigh the potential risks for mother and fetus. Dry powder inhaled budesonide is the only inhaled corticosteroid asthma medication to receive category B status, meaning “there is no evidence of harm to the fetus.”

What exactly does this mean for a pregnant woman with asthma? Since a lack of oxygen can be life threatening for both mother and fetus, the risks associated with poorly controlled asthma often outweigh the risks of taking asthma medications. Share your concerns with your asthma physician and your obstetrician and work together on a treatment plan.