Asthma in pregnancy

Asthma is common, occurring in up to 10% of children and 5 % of adults-and it is becoming commoner. The prevalence of asthma in pregnancy is reported to be 1 YO, but this is likely to be a substantial underestimate because many previously diagnosed individuals do not report their disease, and in many the condition will be undiagnosedjust as in the nonpregnant population. Effective treatment for the overwhelming majority of asthmatics is readily available. The continuing morbidity and mortality from asthma is thus largely preventable. Health professionals and the public are poorly informed about asthma and its treatment and need to be educated to believe that virtual freedom from symptoms should be the norm rather than the exception. One large study showed just how low are the expectations of quality of life of asthmatics, with one quarter of asthmatics self-rated as mild, waking with asthma attacks every single night of their lives (TurnerWarwick 1988). It is conventional to look at any disease in pregnancy from two viewpoints : how does the disease influence pregnancy and its outcome, and how does pregnancy influence the course of the disease? Unfortunately, the lot of the hard-worked obstetrician inevitably encourages the illusion that mother and child cease to exist after a happy, fulfilling and successful delivery, or at latest after the postnatal clinic visit. Asthma is potentially a lifelong condition that not only might influence the pregnancy, but also the relationship between mother and child for years after delivery-most notably and tragically by the death of the mother. Virtually all women come under some form of medical supervision during pregnancy, and detection of asthma and optimisation of its treatment during this short period may have lifelong benefits. Asthma in pregnancy should accordingly be regarded as an opportunity and not only as a potential problem.