Management goals

Asthma management goals for pregnant women with asthma are the same as for other adults. An additional goal for pregnant women with asthma, is to maintain fetal oxygenation by preventing episodes of maternal hypoxia.

It is recommended that the Global Initiative for Asthma (GINA) definition of well-controlled asthma is applied to the management of all pregnant women with asthma (GINA, 2022).

Recommendations for achieving these goals

  • Regular monitoring of clinical symptoms. An asthma review every 4 weeks during pregnancy is recommended, with asthma control assessed each time
  • Provision of self-management education including the correct use of pharmacotherapies
  • A stepwise approach to asthma treatment is recommended during pregnancy as for other adults with asthma
  • Use of short acting β-agonists (SABA) as reliever medication and the use of inhaled corticosteroids (ICS) for women with persistent asthma
  • Continued use of ICS medication that has been effective in controlling asthma prior to pregnancy
  • Multidisciplinary management by all health professionals involved in a woman’s care
  • Identification and management of treatable traits / comorbidities (e.g. rhinitis or gastro-oesophageal reflux), which can contribute to worsening asthma
  • Provide a written Asthma Action Plan with a low threshold for seeking medical help

 For asthma exacerbations:

Pre-conception recommendations

  • Offer advice that uncontrolled asthma or asthma exacerbations put both mothers and babies at risk
  • Provide an asthma review prior to conception including performing baseline spirometry, offering a written Asthma Action Plan
  • Discuss the need to continue taking preventer therapies (if prescribed) when pregnant
  • Smoking cessation advice
  • Vaccinations as required

(Reference: Murphy 2015)