Asthma, the most common chronic condition affecting pregnancy, continues to pose significant risks to maternal and fetal health. That’s according to the comprehensive new paper, “Navigating Asthma in Pregnancy: Immunologic Changes, Barriers and Disparities in Management,” recently published in the journal, Allergy and Asthma Proceedings.
The review examines immunologic changes, treatment barriers and disparities in care, underscoring the urgent need for improved education, evidence‑based guidance and equitable access to asthma management for pregnant patients.
According to the researchers, asthma during pregnancy is associated with increased risks of complications such as low birth weight, preeclampsia and preterm delivery. These outcomes are linked in part to pregnancy‑related immune system changes that are dysregulated in women with asthma.
Additionally, pregnancy alters immune function by shifting the balance of immune cells and inflammatory signals, the authors wrote. In women with asthma, these changes can include a heightened ratio of T helper type 17 (Th17) cells to regulatory T cells, a shift from Th1 to Th2 immune responses and increased proinflammatory cytokines — factors that can worsen asthma severity and control during pregnancy.
Beyond biologic factors, the review identified multiple barriers that interfere with effective asthma management in expectant mothers. These include limited patient education, poor self‑management skills, concerns about medication safety and hesitancy or lack of confidence among health care providers. Socioeconomic disparities — such as those related to race, gender and income — further compound these challenges and contribute to uneven health outcomes, the authors noted.
The researchers conducted a literature analysis using peer‑reviewed studies from the PubMed database published between April 1999 and March 2025. The findings, they noted, point to a critical gap in evidence regarding the safety of asthma medications during pregnancy and lactation as well as a need for stronger provider education and clearer clinical guidance.
The review concluded that allergists and other physicians play a central role in improving outcomes for pregnant patients with asthma. Addressing both the proinflammatory immune environment and broader social and systemic barriers — such as medication nonadherence and health care inequities — will be essential to reducing pregnancy‑related complications and improving maternal and perinatal health, the authors noted.
