Maternal Asthma Control During Pregnancy Linked to Pre-Eclampsia Risk
Poorly controlled maternal asthma and asthma exacerbations during pregnancy may increase the risk of pre-eclampsia, according to a systematic review of 14 studies.
The review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, examined the relationship between asthma control during pregnancy and major pregnancy complications, including pre-eclampsia, low birth weight (LBW), preterm birth, and small for gestational age (SGA).
Study Findings
Researchers evaluated 14 studies that met predefined inclusion criteria to assess whether maternal asthma and asthma control status influence pregnancy and perinatal outcomes.
The review found that maternal asthma itself was consistently associated with an increased risk of delivering infants who were small for gestational age. However, evidence linking asthma alone to other adverse outcomes—including pre-eclampsia, low birth weight, and preterm birth—was inconsistent across studies.
A more notable finding emerged regarding asthma control during pregnancy. Women who experienced asthma exacerbations or had uncontrolled asthma were found to have a higher risk of developing pre-eclampsia compared with those whose asthma was well managed.
In contrast, the evidence did not consistently demonstrate that asthma exacerbations increased the risk of low birth weight, preterm birth, or SGA. While some studies suggested possible associations, the overall findings were contradictory and insufficient to establish a clear relationship.
Clinical Implications
The findings underscore the importance of maintaining optimal asthma control throughout pregnancy. Although asthma alone may not substantially increase the likelihood of most pregnancy complications, uncontrolled disease and exacerbations could contribute to serious maternal outcomes such as pre-eclampsia.
For health care professionals, these results reinforce current recommendations emphasizing regular monitoring of asthma symptoms, adherence to prescribed controller therapies, and proactive management of worsening respiratory symptoms during pregnancy. Effective asthma control may help reduce the risk of pregnancy-related complications while supporting maternal and fetal health.
The review also highlights the need for individualized risk assessment in pregnant patients with asthma. Clinicians should recognize that disease severity and control status may be more clinically relevant than the diagnosis of asthma itself when evaluating obstetric risk.
Reference:
Haastrup EJV, Smedegaard EB, Hansen AV, Ulrik CS. Asthma control during pregnancy and adverse perinatal outcomes: a systematic review. Aust N Z J Obstet Gynaecol . 2026;66(2): e70120. https://obgyn.onlinelibrary.wiley.com/toc/1479828x/2026/66/2
