Asthma in Pregnancy

Asthma is one of the most common chronic diseases affecting pregnant women with variable prevalence around the world. Hormonally mediated and physical changes to the respiratory system occur during pregnancy and can impact asthma status unpredictably-some women improve, some worsen and some are stable. Increased maternal and foetal adverse outcomes are observed with uncontrolled asthma. Medication non-adherence increases in pregnancy, often because of concerns regarding the effect of medications on the developing foetus and is a major contributor to loss of asthma control. Certain comorbidities, particularly metabolic comorbidities, are more common in pregnant women with asthma and are increasingly understood to impact asthma and pregnancy outcomes. There is reassuring observational data to suggest the safety of omalizumab and dupilumab in pregnancy, but more studies are needed. This review highlights the current evidence regarding epidemiology, pregnancy-related respiratory changes, comorbidities and treatment of asthma in pregnancy.