Taking Daily Asthma Medicines During Pregnancy and Avoiding Triggers
Women who have symptoms at least two days a week or two nights a month have persistent asthma, and need daily medication for long-term care of their asthma to prevent exacerbations. Inhaled corticosteroids are the preferred medication to control the underlying inflammation in pregnant women with persistent asthma. There is more data on the safety of budesonide use during pregnancy than on other inhaled corticosteroids; however, there is no data indicating that other inhaled corticosteroids are unsafe during pregnancy, Furthermore, other inhaled corticosteroids may be continued if they effectively control a patient's asthma. Alternative daily medications are leukotriene receptor antagonists, cromolyn, or theophylline.
For patients whose persistent asthma is not well controlled on low doses of inhaled corticosteroids alone, treatment may involve increasing the dose of inhaled corticosteroid or adding another medication -- a long-acting beta agonist.
Oral corticosteroids may be required for the treatment of severe asthma during pregnancy. There is conflicting data regarding the safety of oral corticosteroids during pregnancy; however, severe, uncontrolled asthma poses a definite risk to the mother and fetus; and use of oral corticosteroids may be warranted.
As important as medications are for controlling asthma, a pregnant woman can reduce how much medication is needed by identifying and avoiding the factors that make her asthma worse, such as tobacco smoke or allergens like dust mites.
Also, women with other conditions that can worsen asthma, such as allergic rhinitis, sinusitis, and gastroesophageal reflux, should have those conditions treated as well. Such conditions often become more troublesome during pregnancy.