Maternal asthma during pregnancy and fetal outcomes: potential mechanisms and possible solutions

PURPOSE OF REVIEW: Asthma exacerbations during pregnancy can be a serious complication that have detrimental consequences for both mother and fetus. The pathophysiological mechanisms that cause worsening asthma during pregnancy are only just starting to be examined. This review will examine the recent literature on immune function in pregnant women, immune function in nonpregnant asthma patients and studies conducted on asthma during pregnancy. RECENT FINDINGS: Fifty-five percent of women with asthma will experience at least one exacerbation during pregnancy. This has significant effects on fetal growth and survival, especially if the fetus is male. A number of factors that may contribute to the development of worsening asthma during pregnancy include pregnancy-induced changes in maternal immune function, increased maternal susceptibility to infection, female fetal sex, noncompliance with medication and prepregnancy asthma severity. Interestingly, the immune changes in the maternal system in response to the presence of the fetus and placenta are very similar to the immune changes described in nonpregnant asthma patients with noneosinophilic asthma. SUMMARY: These studies highlight that worsening asthma during pregnancy cannot be attributed to pregnancy alone or asthma alone and may be a complex combination of factors and events