Dear Dr. K;

Dear Dr. K;

My husband and I are pre-planning for our first pregnancy.  I’ve had asthma since I was 11years old, can I stay on my asthma medications while pregnant? 

The short answer is yes.  The emphatic answer is yes, its vital.  The long answer comes next. 

Asthma affects 5 to 8% of women of childbearing age and is one of the most common underlying health conditions that can complicate pregnancy.  Poorly controlled asthma is associated with increased risk of maternal morbidity, spontaneous miscarriage, gestational diabetes, hypertension of pregnancy, pre-term delivery, fetal growth retardation, and congenital abnormalities. 

Therefore, the basic take home message is “control your asthma as well as you can during pregnancy”.  In 2019 the NIH (National Institute of Health) hosted a scientific workshop to better define the safety of asthma medications during pregnancy.  Based on their findings they recommended a six-step approach to treating pregnant asthmatics based on the severity of their condition. 

Step 1 for very mild intermittent asthma was to use a rescue inhaler as needed but no daily “controller” medicine. 

Step 2 for mild persistent asthma was to start a controller medication.  The preferred controller was low dose inhaled steroid but alternative controllers were theophylline, cromolyn, or a leukotriene antagonist (LTRA) such as Singular or Accolate. 

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