Asthma is responsible for 28 million office visits, 1 million emergency room visits, more than 130,000 hospitalizations, and results in approximately 4000 deaths in the United States each year.1It is estimated that asthma affects as many as 4 of all pregnancies, and the incidence appears to be increasing.2When poorly controlled or severe in nature, asthma can cause significant morbidity and mortality in the pregnant patient, including increases in intrauterine growth restriction, low birth weight, and preeclampsia. A recent report by the Working Group on Asthma and Pregnancy found that undertreatment, principally attributable to unfounded fears of fetal affects of medication, is the major problem in the management of asthma during pregnancy in the United States.3This article reviews the most current ideas about the pathophysiology of asthma, discusses the effect of asthma on pregnancy, and outlines an aggressive approach to outpatient treatment designed to reduce or eliminate the increased risks of asthma during pregnancy.
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