The 2015 GINA report clearly states that 1/3 of women with asthma in pregnancy are likely to have their asthma improve during pregnancy, 1/3 remain the same, and 1/3 are likely to worsen. It is important for clinicians to be clearly aware of this, especially in the current healthcare environment, and the need for adequate patient communication. There are many reasons for worsening asthma in pregnancy, for example, patients may be concerned about the impact of asthma treatment on the fetus, so they may reduce or even stop their medication under overly conservative guidance from their physician, which of course can cause asthma to worsen, other reasons include changes in sex hormones, respiratory infections, etc. There is no doubt that worsening asthma can have a significant impact on the fetus. Therefore, prevention of asthma progression is the main focus of asthma treatment in pregnancy. Pregnancy has been a top priority since ancient times, and many pregnant women in our lives are reluctant and afraid to use medication for fear that it will affect the fetus in the womb, which is a great admirable spirit, and each of us comes from parents and should be grateful for it. However, there are very clear norms for the treatment of asthma in pregnancy, and while we worry about it, we must also actively deal with it. It is important to emphasize that although we are constantly concerned about asthma medications affecting pregnancy, the benefits of proactive treatment of asthma during pregnancy far outweigh the potential harms of medications (both controller medications and symptom relievers) (Level A evidence) Current evidence suggests that both ICS (e.g., budesonide, beclomethasone propionate, fluticasone, etc.) and beta2 agonists (e.g. salbutamol, terbutaline, bambuterol, formoterol, salmeterol, etc.), or leukotriene receptor modulators (e.g., montelukast) and theophylline, do not increase the probability of fetal abnormalities. This is important for pregnant women as well as for their physicians. When selecting medications for pregnant women with asthma, it is important to consider the pharmacokinetic properties, efficacy, and risks of each drug. In general, there is a lack of information on the safety of many medications for asthma in pregnant women for ethical reasons; after all, we cannot conduct clinical drug trials in pregnant women. The FDA has developed a drug safety rating system for pregnancy that classifies drugs into 5 classes (A/B/C/D/X). Currently, most drugs for asthma fall into classes B and C. Class B probably means safer, while class C is potentially dangerous and has to be weighed against the pros and cons. There are risks in everything, and one should look at the magnitude of the risks, but also at the ratio of benefits to risks, and strike after a comprehensive consideration, not choking on them, and not being a tiger. No medication is A-rated, which means that there is no absolutely safe medication for women with asthma in pregnancy. Inhaled hormones are naturally the golden role and the top merit for asthma treatment. Of course, inhaled hormones (ICS) are naturally necessary for the treatment of asthma in pregnancy. However, many patients (and even some non-respiratory physicians) talk about hormones, and once they are pregnant they are even more terrified and try to stop them, a behavior that must be drunk. It is well documented that inhaled hormones (ICS) can reduce the worsening of asthma in pregnancy, whereas stopping ICS during pregnancy can lead to worsening of asthma. This is a trade-off: if the asthma is not treated, the fetus will be severely affected if the asthma is poorly controlled or even worsens; if the asthma is treated, there is a risk that the medication will affect the fetus. Obviously, the damage to the fetus caused by worsening asthma is definitely greater than that caused by medication, and it is very important to clearly warn pregnant women about this, because the control of asthma depends largely on the patient’s adherence to treatment. Of course, in addition to considering the safety of the medication, the necessity, effectiveness and route of administration of the medication also need to be taken into account, with inhaled medication being used as much as possible, as this minimizes systemic absorption and effects on the fetus. The above is the management of asthma during the stable phase, do not just stop the previous treatment, especially inhaled hormones. What about acute exacerbation of asthma in pregnancy? Can I use intravenous hormones? Do I need to intervene actively? The answer is: in case of an acute exacerbation of asthma in a pregnant woman, we should be more proactive in taking therapeutic measures rather than hesitating. To avoid fetal hypoxia, SABA, oxygen therapy and systemic hormones should be administered as soon as possible and before it is too late. Although systemic hormones have side effects during pregnancy, their benefits outweigh the harms associated with severe or unstable asthma. The specific treatment plan can be found in the general course and dosage of hormone therapy for adult asthma. As mentioned earlier, severe asthma can lead to many complications during pregnancy if not well controlled, whereas complications during pregnancy are rare if the asthma is properly treated and managed. Pregnancy asthma is a high-risk condition that requires close cooperation between respiratory, obstetrics and gynecology, and even pediatricians, and as a respiratory physician, it is important to have a clear understanding of the principles and details of treatment of pregnancy asthma. However, our textbooks such as Internal Medicine and Obstetrics and Gynecology do not give clear instructions on pregnancy asthma, and even our Chinese version of the asthma guidelines does not seem to mention pregnancy asthma in any way (not excluding the fact that the author himself did not find it), and the GINA guidelines do not devote many pages to “pregnancy asthma”, but the 2015 edition further emphasizes Pregnancy asthma is further emphasized in the 2015 edition.