(from the American Academy of Allergy , Asthma, and Immunology)
How is allergy and asthma treated during pregnancy?
During pregnancy, mothers-to-be may feel uneasy about taking medications. However, if a pregnant woman has allergies and/or asthma, it is doubly important that her symptoms be well-managed to reduce health risks for both her and her baby. Uncontrolled asthma can be a threat to both maternal well-being and fetal growth and survival. Uncontrolled allergies can lead to poor sleep, poor general health and sinus problems, as well as aggravate any coexisting or developing asthma. The goals of allergy and asthma management and treatment during pregnancy are the same as for other patients: to prevent hospitalization, emergency room visits, work loss and promote a healthy pregnancy and newborn.
Pregnant women, like others with allergies and asthma, should avoid their triggers, including specific allergens such as house dust mites and animal dander, and irritants such as cigarette smoke. After discovering you are pregnant, see your allergy and immunology specialist soon after to discuss the best way to manage your allergies and asthma and what medications to take. Your allergy and immunology specialist will be able to prescribe effective asthma and allergy medications that are appropriate to use during pregnancy, and will continue to work with you throughout your pregnancy to ensure your treatment is effective and without side effects. There are many medications that can be taken safely during pregnancy if needed. If you find you are pregnant, call us immediately before you stop any medication so that we can discuss your care.
Frequently Asked Questions
Can women with asthma have safe, full-term pregnancies?
Studies show maternal asthma that is well-managed during pregnancy does not increase the risk of maternal or infant complications. With appropriate asthma management, you can have a healthy baby. Conversely, there is a direct relationship between lower birth weight and uncontrolled asthma. So, it benefits you and your baby to control asthma symptoms.
Why would uncontrolled asthma affect the fetus?
Uncontrolled asthma causes a decrease in the amount of oxygen in the mother’s blood. Since the fetus receives its oxygen from the mother’s blood, decreased oxygen in her blood can lead to decreased oxygen in the fetal blood. This, in turn, can lead to impaired fetal growth and survival, since a fetus requires a constant supply of oxygen for normal growth and development.
How do allergies and asthma medications affect the fetus?
Studies and observations of hundreds of pregnant women with allergies and asthma have demonstrated that most inhaled allergy and asthma medications are appropriate for patients to use while pregnant. The risks of uncontrolled asthma appear to be greater than the risks of necessary asthma medications. However, oral medications, including over the counter medications (except for Claritin and its generic forms) should be avoided unless necessary to control symptoms.
What effect does pregnancy have on allergies and asthma?
Because pregnancy can cause increasing stuffiness of the nose, allergies and sinus problems can become worse during pregnancy. This is not always the case, however, and risks should be discussed with your allergy and immunology specialist. Pregnancy may affect the severity of asthma. One study showed that asthma symptoms worsened in 35% of pregnant women, improved in 28% and remained the same in 33% of the pregnant women. These changes in severity are another reason to stay in close contact with your allergy and immunology specialist so he or she can monitor your condition and alter your medications or dosages, if necessary.
During what part of pregnancy will asthma change?
Asthma has a tendency to worsen during pregnancy in the late second and early third trimesters. However, women may experience fewer symptoms during the last four weeks of pregnancy. Troublesome asthma during labor and delivery is extremely rare in women whose asthma has been adequately controlled during pregnancy.
Can I continue to receive allergy shots during pregnancy?
Immunotherapy (allergy shots) does not have an adverse effect on pregnancy, so it can be continued. As always, your allergy and immunology specialist will monitor your dose to reduce the risk of an allergic reaction to immunotherapy. These reactions are rare; however, such a reaction could be harmful to the fetus. Allergy treatments should not be started for the first time during pregnancy.
Can women with asthma perform Lamaze?
Most women with asthma are able to perform Lamaze breathing techniques without difficulty.
Can I breast feed if I have allergies and asthma?
Breast feeding is a good way to increase your child’s immunity, and is encouraged. The transfer of most drugs into breast milk has not been precisely evaluated; however, there appears to be no evidence that asthma and most allergy medications adversely affect nursing infants. However, some infants may become irritable from theophylline transferred by breast milk. Again, make sure to see your allergy and immunology specialist for the best treatment of allergies and asthma while nursing.
Although these are common questions during pregnancy, each patient’s individual treatment varies. Managing allergy and asthma and avoiding asthma flare-ups during pregnancy is important to the health of the mother and fetus. It is best if women see their allergy and immunology specialists regularly during pregnancy so that any worsening of the allergy and asthma can be countered by appropriate changes in the management program. Make sure to discuss any specific concerns with your physician to ensure the healthiest pregnancy, for your well-being and that of your baby.
Helpful Links
- American Academy of Allergy, Asthma & Immunology http://www.aaaai.org/patients.stm
- American College of Allergy Asthma & Immunology http://acaai.org/public