Breathe Easy During Pregnancy

Nearly 26 million people in the US have asthma, and more than 40% of adults with asthma report having an asthma attack within the last year. Women with severe asthma are more likely to see the condition worsen during pregnancy, so safe and effective medications are essential to have on hand. Allergy shots, oral steroids, biologics, and inhaled corticosteroids are effective, but which treatment option is the safest during pregnancy?

Inhaled relief

People with asthma often rely on inhalers for relief. Short-acting inhalers are taken at the first sign of asthma symptoms for immediate relief. Long-term control inhalers are used daily to prevent symptoms and lower the risk of an asthma attack. Although patients should always double-check the safety of the specific ingredient with an OB/GYN or pharmacist, most inhalers are considered safe during pregnancy. When used correctly, inhaled medication mostly stays in the lungs to provide relief. This means the likelihood of a significant amount of medication entering the bloodstream, crossing the placenta, and reaching the baby is low.

Oral steroids

Another option to effectively treat asthma is the use of oral corticosteroids. This class of medications treats asthma by decreasing airway inflammation and swelling. Some older studies show that corticosteroid use in the first trimester can increase the risk of cleft lip with or without cleft palate. Long-term daily use can also negatively affect the growth of the baby. Depending on the severity of the symptoms, the healthcare provider may approve this type of medication for short-term use in the second or third trimester of pregnancy.

The best biologic

For women with severe asthma resistant to traditional treatment, biologics may help. If this treatment is desired, an allergist will perform a blood test to determine the most effective biologic. Depending on the recommended medication, the treatment is either given intravenously (IV) or by injection every 2-8 weeks. Each treatment option has a different safety profile in pregnancy, so patients will want to get personalized counseling from a doctor once a medication is selected. However, many women are happy to learn that biologics are not expected to cross the placenta in the first trimester, so birth defects are unlikely to be a concern.

Allergy shots

Some individuals get significant relief from allergy shots and want to know if the treatment can be continued during pregnancy. Allergy shots are recommended when asthma is triggered by a known allergen, such as pollen, and involve exposing the individual to small amounts of the environmental trigger to build up resistance. There is not much data on this treatment in pregnancy, so the effects on the developing baby are unknown. The main risk to watch for would be anaphylaxis, which is rare when the immunotherapy gradually increases.

Safe treatment for baby

During pregnancy, every woman wants to make choices that are best for the baby, and this extends to medication use. Although some individuals prefer to skip treatment altogether, the benefits of treating asthma and breathing well often outweigh any risks. Corticosteroids are often avoided in the first trimester, but many other medications can be safely used throughout pregnancy. Inhalers that work locally are a great first-line defense that is not expected to cause problems for the baby. With the proper treatment, asthma can stay controlled.