While a miraculous process, pregnancy can certainly contribute to many health problems (in addition to all the difficulties and struggles of pregnancy itself). Although the statistics are not exact, probably about one third of women with asthma will find their asthma worsens during pregnancy (the good news though, is that about one third of women will also find their asthma may actually improve during pregnancy). When asthma becomes poorly controlled during pregnancy, this makes the pregnancy “high risk.” Similarly, many women find that nasal and eye allergy symptoms worsen during pregnancy. Conditions such as idiopathic urticaria and angioedema may also worsen during pregnancy. Most women will notice at least some difficulty with nasal congestion during pregnancy, often referred to as rhinitis of pregnancy. In many instances, this may become quite severe. Women often wonder what to do with medications during pregnancy and whether their allergen immunotherapy (allergy shots) can be continued during pregnancy.

For the person with asthma, it is best that the asthma be well-controlled before the onset of pregnancy. If pregnancy control deteriorates during pregnancy, it is important that therapy be stepped up as necessary to keep restore asthma control, to minimize risk for both mom and the developing fetus. Most asthma medications can be used in pregnancy. Even though most medications have not been studied with specific regard to safety in pregnancy, there is substantial experience and evidence supporting the use the majority of asthma medications during pregnancy. As such, while it is appropriate to minimize medications during pregnancy when possible (and frankly, at other times as well), it is most important to use medications as necessary to maintain or restore asthma control.

Also, most medications used for allergy can be used during pregnancy if needed. While this issue is not as critical as asthma, it is still as significant concern for many people. Furthermore, poor control of nasal allergy (and related problems) can be associated with worse asthma control.

Allergen immunotherapy (allergy shots) can be (and very frequently are) continued during pregnancy, although typically these would not be started during pregnancy. During pregnancy, however, the maintenance dose is typically reduced somewhat, and then the dose is built back up after delivery. Allergy shot doses are not increased (the dose is not built-up) during pregnancy.

If you are pregnant or are planning on pregnancy, schedule an appointment to make sure asthma and allergies are well-controlled. The appointment will be a good opportunity to ask questions about treatments for asthma and allergic diseases during pregnancy and to modify your treatment if necessary.