Asthma in Pregnancy. Review of Current Literature and Recommendations

Background:Asthma is the most common respiratory disorder affecting women during pregnancy. Although it is a reversible disease, it may adversely affect maternal quality of life and perinatal outcomes, especially in severe and inappropriately managed cases. Conversely, pregnancy influences the course of asthma through the physiological respiratory, hormonal, and immune system changes. Exacerbations are a key feature of asthma, representing a significant problem if severe, requiring aggressive medical intervention, hospital and even ICU admission. Purpose: The purpose of this article is to summarize the current knowledge and to provide a comprehensive overview of asthma in pregnancy. We also want rising awareness among patients and clinicians on the importance of proper asthma management during pregnancy. Data sources: A comprehensive literature search in PubMed, Medline, and Taylor& Francis was performed. We have searched for review articles as well as prospective and retrospective studies published in English, investigating the bilateral relationship between asthma and pregnancy, using the key words mentioned bellow. Manual search through both national and international guidelines as well as relevant journals and publications on the topic has been also conducted. Conclusion:Optimal asthma control, preventing, detecting, and treating the exacerbations are of the utmost importance to minimize the adverse effects for both the mother and fetus/neonate. Guidelines recommend active asthma management during pregnancy. Strong support prior and throughout the pregnancy and individualized treatment, guided by a multidisciplinary team, is suggested. Education on the importance of anti-asthmatic therapy, avoiding triggers, frequent and accurate monitoring are essential for good asthma management. Considering the pandemic, we are facing and the potential impact of COVID-19 on asthma, Global Initiative for Asthma (GINA) guideline recommendations for physicians are mentioned in the present article.