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Respiratory disease in pregnancy
Authors:Sophia Stone  Catherine Nelson-Piercy
Institution:1. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Hangkong Road 13, Wuhan 430030, China;2. Office for Disease Control and Emergency Response, Chinese Centre for Disease Control and Prevention (CDC), Beijing, China;1. Departamento de Farmacobiología, Cinvestav-Coapa, Czda. de los Tenorios 235, Col. Granjas-Coapa, Deleg. Tlalpan, C.P. 14330 Ciudad de México, Mexico;2. Facultad de Ciencias Químicas, Universidad Autónoma de Coahuila, Boulevard Venustiano Carranza esquina con Ing. José Cárdenas Valdés, Colonia República, Saltillo, C.P. 25280 Coahuila, Mexico;1. Department of Genetic Medicine, Weill Cornell Medical College, New York, New York;2. Department of Genetic Medicine, Weill Cornell Medical College-Qatar, Doha, Qatar;3. Department of Biological Statistics and Computational Biology, Cornell University, Ithaca, New York;4. Department of Medicine, Hamad Medical Corporation, Doha, Qatar;5. Department of Medicine, Weill Cornell Medical College, New York, New York;1. Manitoba Developmental Origins of Chronic Diseases in Children Network (DEVOTION); Children''s Hospital Research Institute of Manitoba, Winnipeg, Canada;2. Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada;3. Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Canada;4. Applied Health Sciences, University of Manitoba, Winnipeg, Canada;5. Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Canada;1. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md;2. Northwestern University Feinberg School of Medicine, Chicago, Ill;3. University of Alabama at Birmingham, Birmingham, Ala;4. Ochsner Health, New Orleans, La;5. The Emmes Company, Rockville, Md;6. University at Buffalo, Buffalo, NY;1. University North Carolina, Chapel Hill, Gillings School of Global Public Health, 8 Department of Epidemiology, Chapel Hill, NC 27599;2. Department of Biostatistics, University of North Carolina, Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC 27599;3. Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN 37203;4. Department of Pediatrics, School of Medicine, University of California, San Diego, La Jolla, CA 92093;5. Division of Child Development and Community Health, University of California, San Diego, San Diego, CA 92103
Abstract:Breathlessness in the absence of an underlying pathology is common in pregnancy, but serious causes should be excluded depending on symptoms. The use of chest X-rays should not be avoided in pregnancy.Asthma affects about 7% of women of child-bearing age. Treatment is the same as for the non-pregnant population and most drugs are safe in pregnancy. It is important to educate women to continue inhaled corticosteroid preventer therapy to reduce the risk of attacks. Respiratory infections are associated with a higher morbidity in pregnancy and should be treated aggressively.Women with a chronic respiratory disease should receive pre-pregnancy counselling and education, and during pregnancy managed in a multidisciplinary setting with the respiratory team. Most chronic pulmonary diseases do not alter fertility, and in the majority of cases large reserves in respiratory function allow a good pregnancy outcome for fetus and mother. In contrast, the presence of pulmonary hypertension and cor pulmonale is associated with a high risk of death in pregnancy.
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