Asthma and pregnancy: Understanding the dynamic relationship - A comprehensive review

Riya Pawar; Alka Rawekar

doi:10.31893/multirev.2025025

Keywords:

rhinitis

pharmacological treatment

Abstract

The health of pregnant women and their developing fetuses can be greatly impacted by asthma, a prevalent chronic respiratory disease. Pregnancy-related asthma is a serious health risk. A potentially fatal condition that makes many pregnancies more difficult is asthma. The prevalence of asthma has increased within the past few decades. This comprehensive review explored the complex connection between asthma and pregnancy. Analyzing physiological alterations during pregnancy revealed dynamic interactions between immunological responses and respiratory function. These Important discoveries highlight the susceptibility to exacerbations of asthma. This discussion focuses on the links between poorly managed asthma and unfavourable - perinatal outcomes, with particular attention given to maternal and fetal outcomes, tracking and tailored treatment to provide the best possible management of asthma. This review emphasizes how important it is to manage asthma throughout pregnancy because it can have a positive impact on both the mothers and fetuses long-term health. Consequences for clinical practice emphasize the value of preconception care, ongoing surveillance, and joint obstetrician-pulmonologist efforts. This review also sheds light on how common asthma is in expectant mothers, and this field's future directions require further investigation. Low birth weights and small for gestational age are associated with a greater risk, especially in women who have moderate-to-severe asthma and have episodes of the condition during pregnancy. Additionally, there was a slight but statistically significant increase in the chance of congenital deformities. By preventing exacerbations, active management may lessen these risks. Ensuring optimal management of asthma during pregnancy is crucial for the welfare of the expectant mother and the unborn child. While poorly managed and undertreated asthma is linked to a number of dangers for both mothers and fetuses, well-controlled asthma reduces the risk of complications for both mothers and fetuses.
References
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11. Dodd, V. (1996). Gestational age assessment. Neonatal Network: NN, 15(1), 27–36.
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13. Gade, E. J., Tidemandsen, C., Hansen, A. V., Ulrik, C. S., & Backer, V. (2022b). Challenges in the successful management of asthma during conception, pregnancy and delivery. Breathe (Sheffield, England), 18(2), 220013. https://doi.org/10.1183/20734735.0013-2022
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21. Piché, M.-E., Tchernof, A., & Després, J.-P. (2020). Obesity Phenotypes, Diabetes, and Cardiovascular Diseases. Circulation Research, 126(11), 1477–1500. https://doi.org/10.1161/CIRCRESAHA.120.316101
22. Rey, A., Jassem, E., & Chelminska, M. (2019). Evaluation of asthma course in pregnancy. Ginekologia Polska, 90(8), 464–469. https://doi.org/10.5603/GP.2019.0080
23. Robinson, J. L., Gatford, K. L., Clifton, V. L., Morrison, J. L., & Stark, M. J. (2023). The impact of maternal asthma on the fetal lung: Outcomes, mechanisms and interventions. Paediatric Respiratory Reviews, S1526-0542(23)00086-6. https://doi.org/10.1016/j.prrv.2023.12.004
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26. Sio, Y. Y., & Chew, F. T. (2021). Risk factors of asthma in the Asian population: A systematic review and meta-analysis. Journal of Physiological Anthropology, 40(1), 22. https://doi.org/10.1186/s40101-021-00273-x
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28. Tibrewal, C., Modi, N. S., Bajoria, P. S., Dave, P. A., Rohit, R. K., Patel, P., Gandhi, S. K., Gutlapalli, S. D., Gottlieb, P., & Nfonoyim, J. (2023). Therapeutic Potential of Vitamin D in Management of Asthma: A Literature Review. Cureus, 15(7), e41956. https://doi.org/10.7759/cureus.41956
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30. Vanders, R. L., & Murphy, V. E. (2015b). Maternal complications and the management of asthma in pregnancy. Women’s Health (London, England), 11(2), 183–191. https://doi.org/10.2217/whe.14.69
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33. Williamson, G. R., O’Connor, A., & Kayleigh, E.-J. (2017). Women’s experiences of personalised support for asthma care during pregnancy: A systematic review of the literature. BMC Pregnancy and Childbirth, 17(1), 69. https://doi.org/10.1186/s12884-017-1241-8
34. Zairina, E., Stewart, K., Abramson, M. J., & George, J. (2014). The effectiveness of non-pharmacological healthcare interventions for asthma management during pregnancy: A systematic review. BMC Pulmonary Medicine, 14, 46. https://doi.org/10.1186/1471-2466-14-46

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

How to cite

Pawar, R., & Rawekar, A. (2024). Asthma and pregnancy: Understanding the dynamic relationship - A comprehensive review. Multidisciplinary Reviews, 8(1), 2025025. https://doi.org/10.31893/multirev.2025025

[1] Al-Hussainy, A., & Mohammed, R. (2021). Consequences of maternal psychological stress during pregnancy for the risk of asthma in the offspring. Scandinavian Journal of Immunology, 93(1), e12919. https://doi.org/10.1111/sji.12919

[2] Bjelica, A., Cetkovic, N., Trninic-Pjevic, A., & Mladenovic-Segedi, L. (2018). The phenomenon of pregnancy—A psychological view. Ginekologia Polska, 89(2), 102–106. https://doi.org/10.5603/GP.a2018.0017

[3] Bonham, C. A., Patterson, K. C., & Strek, M. E. (2018). Asthma Outcomes and Management During Pregnancy. Chest, 153(2), 515–527. https://doi.org/10.1016/j.chest.2017.08.029

[4] Bousquet, J., Anto, J. M., Bachert, C., Baiardini, I., Bosnic-Anticevich, S., Walter Canonica, G., Melén, E., Palomares, O., Scadding, G. K., Togias, A., & Toppila-Salmi, S. (2020). Allergic rhinitis. Nature Reviews. Disease Primers, 6(1), 95. https://doi.org/10.1038/s41572-020-00227-0

[5] Bravo-Solarte, D. C., Garcia-Guaqueta, D. P., & Chiarella, S. E. (2023). Asthma in pregnancy. Allergy and Asthma Proceedings, 44(1), 24–34. https://doi.org/10.2500/aap.2023.44.220077

[6] Carvalho-Pinto, R. M. de, Cançado, J. E. D., Caetano, L. S. B., Machado, A. S., Blanco, D. C., Garcia, G. F., Figueiredo, R. G., & Bartholo, T. P. (2023). Asthma and pregnancy. Revista Da Associacao Medica Brasileira (1992), 69(suppl 1), e2023S123. https://doi.org/10.1590/1806-9282.2023S123

[7] Couillard, S., Connolly, C., Borg, C., & Pavord, I. (2021). Asthma in pregnancy: An update. Obstetric Medicine, 14(3), 135–144. https://doi.org/10.1177/1753495X20965072

[8] Crowe, H. M., Wise, L. A., Wesselink, A. K., Rothman, K. J., Mikkelsen, E. M., Sørensen, H. T., Walkey, A. J., & Hatch, E. E. (2020). Association of Asthma Diagnosis and Medication Use with Fecundability: A Prospective Cohort Study. Clinical Epidemiology, 12, 579–587. https://doi.org/10.2147/CLEP.S245040

[9] Pallavi Yadav (2023). A Comprehensive review on asthma challenges in pregnancy exploring first trimester exacerbations and the spectrum of congenital anomalies. https://www.cureus.com. Accessed on February 10,2024.

[10] Dimitriadis, E., Rolnik, D. L., Zhou, W., Estrada-Gutierrez, G., Koga, K., Francisco, R. P. V., Whitehead, C., Hyett, J., da Silva Costa, F., Nicolaides, K., & Menkhorst, E. (2023). Pre-eclampsia. Nature Reviews. Disease Primers, 9(1), 8. https://doi.org/10.1038/s41572-023-00417-6

[11] Dodd, V. (1996). Gestational age assessment. Neonatal Network: NN, 15(1), 27–36.

[12] Gade, E. J., Tidemandsen, C., Hansen, A. V., Ulrik, C. S., & Backer, V. (2022a). Challenges in the successful management of asthma during conception, pregnancy and delivery. Breathe (Sheffield, England), 18(2), 220013. https://doi.org/10.1183/20734735.0013-2022

[13] Gade, E. J., Tidemandsen, C., Hansen, A. V., Ulrik, C. S., & Backer, V. (2022b). Challenges in the successful management of asthma during conception, pregnancy and delivery. Breathe (Sheffield, England), 18(2), 220013. https://doi.org/10.1183/20734735.0013-2022

[14] Goldenberg, M., Danovitch, I., & IsHak, W. W. (2014). Quality of life and smoking. The American Journal on Addictions, 23(6), 540–562. https://doi.org/10.1111/j.1521-0391.2014.12148.x

[15] Hammad, H., & Lambrecht, B. N. (2021). The basic immunology of asthma. Cell, 184(6), 1469–1485. https://doi.org/10.1016/j.cell.2021.02.016

[16] Joshi, E., Gibson, P. G., McDonald, V. M., & Murphy, V. E. (2023). Treatable traits in asthma during pregnancy: A call for a shift towards a precision-based management approach. European Respiratory Review: An Official Journal of the European Respiratory Society, 32(170), 230105. https://doi.org/10.1183/16000617.0105-2023

[17] Kher, S., & Mota, P. (2017). Maternal asthma: Management strategies. Cleveland Clinic Journal of Medicine, 84(3), 296–302. https://doi.org/10.3949/ccjm.84a.15046

[18] Labor, S., Dalbello Tir, A. M., Plavec, D., Juric, I., Roglic, M., Pavkov Vukelic, J., & Labor, M. (2018). What is safe enough—Asthma in pregnancy—A review of current literature and recommendations. Asthma Research and Practice, 4, 11. https://doi.org/10.1186/s40733-018-0046-5

[19] Murphy, V. E. (2015). Managing asthma in pregnancy. Breathe (Sheffield, England), 11(4), 258–267. https://doi.org/10.1183/20734735.007915

[20] Pape, K., Liu, X., Sejbæk, C. S., Andersson, N. W., Larsen, A. D., Bay, H., Kolstad, H. A., Bonde, J. P. E., Olsen, J., Svanes, C., Hansen, K. S., Rugulies, R., Hougaard, K. S., & Schlünssen, V. (2021). Maternal life and work stressors during pregnancy and asthma in offspring. International Journal of Epidemiology, 49(6), 1847–1855. https://doi.org/10.1093/ije/dyaa133

[21] Piché, M.-E., Tchernof, A., & Després, J.-P. (2020). Obesity Phenotypes, Diabetes, and Cardiovascular Diseases. Circulation Research, 126(11), 1477–1500. https://doi.org/10.1161/CIRCRESAHA.120.316101

[22] Rey, A., Jassem, E., & Chelminska, M. (2019). Evaluation of asthma course in pregnancy. Ginekologia Polska, 90(8), 464–469. https://doi.org/10.5603/GP.2019.0080

[23] Robinson, J. L., Gatford, K. L., Clifton, V. L., Morrison, J. L., & Stark, M. J. (2023). The impact of maternal asthma on the fetal lung: Outcomes, mechanisms and interventions. Paediatric Respiratory Reviews, S1526-0542(23)00086-6. https://doi.org/10.1016/j.prrv.2023.12.004

[24] Shaikh et al.(2023). Fertility challenges in asthmatic women: examining the complexities of pregnancy loss, infertility, and assisted reproductive technologies. Cureus, 15(8), e43104. https://www.cureus.com. Accessed on February 10,2024.

[25] Shaikh, M. Y. D., Shaikh, M. D., Hirani, S., Nanote, A., Prasad, R., Wanjari, M., Shaikh, M. Y. D., Shaikh, M. D., Hirani, S., Nanote, A., Prasad, R., & Wanjari, M. (2023). Fertility Challenges in Asthmatic Women: Examining the Complexities of Pregnancy Loss, Infertility, and Assisted Reproductive Technologies. Cureus, 15(8). https://doi.org/10.7759/cureus.43104

[26] Sio, Y. Y., & Chew, F. T. (2021). Risk factors of asthma in the Asian population: A systematic review and meta-analysis. Journal of Physiological Anthropology, 40(1), 22. https://doi.org/10.1186/s40101-021-00273-x

[27] Soma-Pillay, P., Nelson-Piercy, C., Tolppanen, H., & Mebazaa, A. (2016). Physiological changes in pregnancy. Cardiovascular Journal of Africa, 27(2), 89–94. https://doi.org/10.5830/CVJA-2016-021

[28] Tibrewal, C., Modi, N. S., Bajoria, P. S., Dave, P. A., Rohit, R. K., Patel, P., Gandhi, S. K., Gutlapalli, S. D., Gottlieb, P., & Nfonoyim, J. (2023). Therapeutic Potential of Vitamin D in Management of Asthma: A Literature Review. Cureus, 15(7), e41956. https://doi.org/10.7759/cureus.41956

[29] Vanders, R. L., & Murphy, V. E. (2015a). Maternal complications and the management of asthma in pregnancy. Women’s Health (London, England), 11(2), 183–191. https://doi.org/10.2217/whe.14.69

[30] Vanders, R. L., & Murphy, V. E. (2015b). Maternal complications and the management of asthma in pregnancy. Women’s Health (London, England), 11(2), 183–191. https://doi.org/10.2217/whe.14.69

[31] Vyawahare et al. (2023). Asthma in pregnancy: A critical review of impact, management, and outcomes. Cureus, 15(12), e50094. https:// www.cureus.com. Accessed on February 10,2024.

[32] Wang, H., Li, N., & Huang, H. (2020). Asthma in Pregnancy: Pathophysiology, Diagnosis, Whole-Course Management, and Medication Safety. Canadian Respiratory Journal, 2020, 9046842. https://doi.org/10.1155/2020/9046842

[33] Williamson, G. R., O’Connor, A., & Kayleigh, E.-J. (2017). Women’s experiences of personalised support for asthma care during pregnancy: A systematic review of the literature. BMC Pregnancy and Childbirth, 17(1), 69. https://doi.org/10.1186/s12884-017-1241-8

[34] Zairina, E., Stewart, K., Abramson, M. J., & George, J. (2014). The effectiveness of non-pharmacological healthcare interventions for asthma management during pregnancy: A systematic review. BMC Pulmonary Medicine, 14, 46. https://doi.org/10.1186/1471-2466-14-46

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References

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