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Asthma in Women
Asthma in Pregnancy

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• Definition and Causes of Asthma
• The Magnitude of the Problem
• Diagnosis (Symptoms) - How Does a Woman Know She Has Asthma?
• Epidemiology: Who Gets Asthma? Is Asthma Different In Men and Women?
• Complications
• Prognosis: How is Asthma Different in Pregnancy?
• Prevention of Asthma and Asthma Attacks
• Treatment: Overview
  • Non Pharmacologic (Non-Medication) Intervention
  • Treatment With Medication: General Considerations
  • A. Rescue Medication: Inhaled for Quick Relief
  • B. Maintenance Therapy: Inhaled for Long-Term Control
  • C. Maintenance Therapy: Oral (by mouth) for Long-Term Control
  • D. Use of Medications: Optimizing Their Effects and Safety
  • E. Treatment & Monitoring Based on the Type of Asthma

• Summary of Treatment Issues Specific to Asthma and Pregnancy

Definition and Causes of Asthma

Twenty percent of the U.S. population has allergies or asthma (6).

Asthma is a disease of chronic inflammation of the airways (the tubes bringing air to the lungs). The inflammation makes breathing difficult. How asthma affects a person fluctuates with a person's various environmental and medical conditions. Asthma can be life-threatening. It is not contagious. Symptoms can start at any age.

Asthma is defined as a chronic inflammatory disease of the airways (2), the airways being the tubes in the lungs that bring in critical supplies of oxygen from the air into the body. It is included in one of the two major categories lung diseases called obstructive lung diseases, also included is chronic obstructive pulmonary disease usually caused by smoking. These obstructive lung diseases are conditions in which the air can come in, but the exit of air, called expiration, is impaired, in other words obstructed or blocked. The cause of this blockage is usually narrowed airways and increased mucus.

In asthma, a person's lungs react excessively to many triggers (stimuli). Frequently, an asthmatic person is also allergic, and the allergic trigger is the cause of an asthma attack. Other causes of asthma attacks (also called exacerbations) include smoking, environmental pollution, exercise, and upper respiratory infections, such as the common cold or bronchitis. Viral infections are being increasingly recognized as major triggers of asthma attacks. These infections may be found in the future to be even more important than other asthma triggers. Although the attacks can last for only minutes before resolving, sometimes acute asthma exacerbations last for days or weeks. They can even be fatal.

It is becoming more and more clear that asthma and gastroesophageal reflux can often occur in the same person. Gastroesophageal reflux is a condition of irritation and inflammation of the esophagus due to contact of the stomach contents with the lining of the esophagus. Although the cause and effect of how asthma and reflux are related are blurry, in terms of which one triggers the other, when the two conditions (not infrequently) occur in the same person they can trigger each other.

There may be genetic component to asthma, meaning that the built-in messages physically passed on from birth from our parents may play a role. It has long been observed that asthma sometimes "runs in families". Already genes causing susceptibility to asthma in such families are being discovered.