Asthma in Women, Asthma in Pregnancy (cont.)
Prognosis: How is Asthma Different in Pregnancy?
All women are different. The course that asthma will take when an asthmatic
woman becomes pregnant is impossible to predict beforehand. Furthermore, there
is research evidence suggesting that women with asthma are higher risk of having
pre-term infants, low birth-weight infants, infants small for their gestational
age, increased hospital stays, and other complications. There is strong medical
basis to believe that the risk of using asthma medication in pregnancy is
minuscule compared to the risk of NOT treating the asthma.
Prevention of Asthma and Asthma Attacks
Something Usually Triggers an Asthma Attack
An asthma attack occurs when
the airways narrow (the process called
bronchoconstriction) and inflamed, usually as a result of an asthma trigger.
Obviously, if a woman knows certain things trigger her asthma, she should try to
avoid exposure to them whenever possible. Usually, something is responsible for
triggering asthma flares. The following are issues regarding asthma triggers and
prevention of asthma symptoms.
In terms of asthma in children, research is growing daily that strongly
suggest that if we abolished exposure of children to cigarette smoking we could
actually prevent some cases of asthma. Exposure to cigarette smoke is a risk
factor for asthma.
Pregnant asthmatics should avoid not only smoking
but also exposure to side-stream tobacco smoke.
In families with strong atopic (asthma, allergic eczema
rashes, hay fever) tendencies, it is
recommended that the infant be fed exclusively with breastmilk as opposed to
formula, to decrease the infants risk of getting allergic food
sensitivities.
Smoking is a well-known asthma attack
trigger. Smoking (even just being around someone who is smoking), feathers,
mold, and cold air are frequent
culprits that should be avoided if possible.
Unfortunately, respiratory viruses
are very common triggers of asthma and are
often not preventable. It is a good idea to avoid people with known respiratory
infections. Influenza vaccination is recommended
for asthmatics who will be in the second and third trimesters of pregnancy at
the time of annual influenza seasons. Rhinitis (hay fever, reaction to trees and grasses), sinusitis, and gastroesophageal
reflux (irritation of the esophagus caused by the gastric
contents, see above) can also contribute to asthma.
Respiratory reactions to food can occur when people do not recognize that
their trigger food is hidden in the food they are eating. Smoke from food
cooking, or a wood-burning fireplace, can also trigger an asthma attack.
Exercise can cause
bronchoconstriction in about 70% of asthmatics. This is thought to be partly
because exercise prevents the nose from warming and humidifying the air, since
mouth-breathing is common during exercise. However, a physician's role is to
instruct a woman on how to use appropriate treatments so that she will be able
to exercise without having the asthma stop her from
achieving her desired activity level. There is medication available to use right
before exercise to help prevent exercise-induced symptoms. Changes in the
weather can trigger asthma. Dry cold air may be especially bothersome.
Strong smells or sprays can trigger asthma and should be avoided when
possible. These things can irritate people without asthma, but people with
asthma are even more sensitive to them. Soaps or shampoos also often contain
perfume and should be avoided.
A recent report from the Nurses' Health Study found that increasing weight
(as adjusted for height) was associated with increasing risk of asthma in women.
The study also found that weight gain after age 18 was strongly associated with
risk of adult-onset asthma.
Some people's asthma is triggered by aspirin, though these
people represent a very small portion of asthmatics overall. A physician can help determine which
particular asthma patients are at risk for aspirin-induced asthma.
Avoiding triggers may
help both in averting the acute asthma attack and also over time in improving
asthma control.
Treatment Overview
Asthma can be controlled. It requires good communication with a treating
physician. There is no reason to settle for lack of improvement in asthma
symptoms. Taking care of asthma means carrying out both environmental and
medication plans. An asthma episode can often be halted if treated early with
medication. People who do not realize or believe that are at risk of dying from
asthma. Research confirms that in the community, asthma patients usually have a
good prognosis in other words that they have similar survival compared to people
in the community without asthma.
Many of the hospitalizations and deaths resulting from asthma can be
prevented, but only if people: recognize the symptoms, act on symptoms quickly,
avoid asthma triggers, take the correct medications regularly and in correct
fashion, and get good education regarding asthma and asthma medications. Some ways to accomplish these goals are discussed below.
Non Pharmacologic (Non-Medication) Intervention
Dust can have mold, animal
dander, and dust mites in it. The dust mite is a tiny creature that lives in
bedding and furniture as well as carpet. Dust mites are more plentiful in the
summer and have trouble surviving in the winter. Dust mite waste products are
the cause of allergic reactions. Although dust may cause inflammation in most
people, in asthmatics it can cause bronchial constriction (narrow of the
airways) and hyper-responsiveness (excessive "twitchiness" of the airways,
tendency of the airways to spasm). It is recommended that people susceptible to
asthma attempt to eliminate dust sources. Methods to do this include eliminating
carpeting, covering mattresses and pillows with special allergy covers (plastic with a zipper, available in many major linen store
chains), and washing bedding frequently in hot water. Hot temperatures are
necessary for killing the dust mites. Feathers and down are probably not wise to
have around asthmatics, nor is wool. As much as possible furniture should be
minimal and not upholstered, and dust-prone venetian blinds should be
restricted. Curtains should be washed weekly in hot water. Use of pillows or
mattresses made of straw is not recommended. Extra throw rugs and old moldy
dusty stuffed animals or throw pillows should probably be removed. The best toys
are probably those made of washable materials that are not likely to hold dust.
Wood is a good toy material from the asthma standpoint.
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