FACT: 30 percent of women who have asthma find that their condition improves in pregnancy.
Any pregnancy -- and especially your first -- is bound to bring worry. But when you have a condition such as asthma, epilepsy, or an autoimmune disease, it's natural to be even more concerned. Chronic diabetes and high blood pressure are perhaps the best-known conditions women need to manage while pregnant, but the four chronic disorders profiled here can also be worrisome to women and their doctors. Here's what you need to know to ensure a healthy pregnancy and baby if you have one of these conditions.
If you have asthma, which affects roughly eight percent of pregnant women, be prepared for a possible change in your condition, says Martha V. White, MD, research director at the Institute for Asthma and Allergy, in Wheaton, Maryland. "About 30 percent of pregnant women with asthma will have asthma that gets worse, for about 30 percent it will get better, and for the other third it stays the same," she explains, and she adds that it's nearly impossible to predict which camp you'll fall into.
This means that during pregnancy you should see your allergist or pulmonologist every month for a lung function test to check if your medications need to be adjusted. It's likely you'll also self-monitor your breathing with a device called a "peak flow meter," which determines how open your airways are.Will Asthma Medication Affect My Baby?
Not surprisingly, the biggest question facing an asthmatic mother-to-be is whether the drugs she is taking will affect her baby. While albuterol and inhaled steroids are considered safe in pregnancy, other newer asthma medications, like Advair, do not have a proven track record. You'll need to work with your doctor to find the drug combination that's right for you.
Whenever possible, Dr. White chooses inhaled drugs for her pregnant patients. "That way the lungs see the drugs, but the rest of the woman's body doesn't," she explains. This reduces the fetus's exposure to the drugs. Severe asthma might need to be treated with oral corticosteroids like prednisone, which has not been established as safe for pregnant women. However, severe, uncontrolled asthma poses a worse risk -- after all, the fetus will be deprived of oxygen that it needs, too, so the use of these medications might be warranted.
Because you're breathing for two, it's vital to stay on top of symptoms. Ideally, you'll stop them before they start. Keep a lid on asthma triggers such as animal dander, respiratory infections, smoke, dust mites, pollen, cockroaches, and indoor mold. Unless the asthma is very mild, most asthmatic women take both an anti-inflammatory medication and a fast-acting drug to treat wheezing and shortness of breath. The condition tends to worsen during the second trimester and most of the third, so make a particular effort to keep symptoms under control during this period.
On the upside, symptoms might improve during the last month of pregnancy, thanks to hormonal changes, says Dr. White. Interestingly, a 2006 study in the American Journal of Epidemiology found that pregnant women carrying a girl were likely to have worse asthma symptoms than those expecting a boy; researchers think that the androgens (male sex hormones) boys produce might have a protective effect for asthmatic moms-to-be, especially from the second trimester on.