Asthma is the most common chronic disease to affect pregnant women, and the prevalence of asthma is rising worldwide. In Australia, 12% of pregnant women have asthma, and up to 45% have an exacerbation of their asthma which requires medical intervention during pregnancy. Exacerbations have been associated with poor perinatal outcomes, including low birth weight and preterm birth. A systematic review and meta-analysis of the literature indicated that the risk for preterm birth was lowered when women’s asthma was actively managed, suggesting that asthma is a modifiable risk factor for adverse perinatal outcomes. In this talk, novel management strategies which have been tested in randomised controlled trials will be discussed. One of these RCTs used a measure of eosinophilic lung inflammation (exhaled nitric oxide) to adjust asthma treatment with inhaled corticosteroids (ICS) and compared this to a symptoms-based approach. The novel strategy reduced exacerbations by 50%, altered the treatment profile (more women received inhaled corticosteroids but at a lower mean dose), and significantly improved quality of life. At one year of age, infants were significantly less likely to have experienced multiple episodes of bronchiolitis, and by 4-6 years of age, fewer children had doctor diagnosed asthma. This intervention improved outcomes for women with asthma during pregnancy, and represents the first evidence of a primary prevention strategy for asthma among children at high risk.