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Asthma, Allergies & Pregnancy

Submitted by on September 17, 2015 – 10:45 amNo Comment

How to treat allergies and asthma during pregnancy

How to Treat Asthma and Allergies During Pregnancy

You are expecting! This is an exciting time filled with hope and expectations; however, for many women it can be filled with questions and concerns due to asthma. One in 100 pregnant women will experience asthma symptoms during pregnancy and many more will experience allergy or hay fever symptoms. It is important to ask your healthcare professional to determine which medicines are safe and recommended to help you control symptoms during pregnancy.

Antihistamines may be useful to treat the nasal and eye symptoms of allergic rhinitis, allergic conjunctivitis, the itching of hives or eczema. With the exception of life-threatening anaphylaxis, the benefits from their use must be weighed against any risk to the fetus. Because symptoms may be of such severity to affect maternal eating, sleeping or emotional well-being, and because uncontrolled rhinitis may pre-dispose to sinusitis or may worsen asthma, antihistamines may provide definite benefit during pregnancy.

The use of decongestants is more problematic. The nasal spray oxymetazoline (Afrin, Neo-Synephrine, etc.) appears to be the safe because there is minimal absorption into the blood stream. However, these nasal sprays can cause rebound congestion and actually worsen the condition for which they are used. Their use is generally limited to less than three consecutive days.  Use of oral decongestants during the first trimester should only be entertained after consideration of the severity of maternal symptoms unrelieved by other medications.

A corticosteroid nasal spray should be considered in any patient whose allergic nasal symptoms are more than mild and last for more than a few days. These medications prevent symptoms and lessen the need for oral medications. There are few specific data regarding the safety of intranasal corticosteroids during pregnancy. However, based on the data for the same medications used in an inhaled form (for asthma), budesonide (Rhinocort) would be considered the intranasal corticosteroid of choice, but other intranasal corticosteroids could be continued if they were providing effective control prior to pregnancy.

Allergen immunotherapy (allergy shots) is often effective for those patients in whom symptoms persist despite optimal environmental control and proper drug therapy. Allergen immunotherapy can be carefully continued during pregnancy in patients who are benefiting and not experiencing adverse reactions. Due to the greater risk of anaphylaxis with increasing doses of immunotherapy and a delay of several months before it becomes effective, it is generally recommended that this therapy not be started during pregnancy.

It is extremely important to monitor closely any asthma or allergic problems during your pregnancy. In the vast majority of cases, you and your child can look forward to a good outcome, even if your asthma is severe, so long as you follow your doctor’s instructions carefully. At the very first signs of breathing difficulty, call your doctor.

Remember the danger of providing an inadequate supply of oxygen to your baby is a much greater risk than taking the commonly used asthma medications.

Tonya Winders, MBA is currently the President and Chief Executive Officer of Allergy & Asthma Network, the leading patient advocacy organization dedicated to ending the needless death and suffering due to asthma, allergies and related conditions. Tonya has over 16 years’ experience in leadership roles within the allergy and asthma industry. From sales and marketing leadership to managed markets access, she has worked tirelessly to ensure patients have access to effective diagnostic and treatment tools. Tonya has worked closely with the leadership of the ACAAI & AAAAI to address challenges currently facing the integrity of allergy and asthma care throughout the US while spreading awareness and preparedness messages to patients and caregivers. Personally, Tonya is the mother of five children, four of whom have asthma and/or allergies, ranging in age from 9-15 years old. She enjoys spending time with her husband of 18 years Brian Winders and coaching cheerleading. AllergyAsthmaNetwork.org

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