Pregnancy / Childbirth

Allergies in pregnancy - symptoms worsen or calm down?

About 18 to 30% of women of childbearing potential suffer from allergic diseases and constantly or temporarily taking medication because of them. This is a special problem during pregnancy and breastfeeding. For this reason, it is worth knowing the answer to the question: can allergic diseases contribute to the development of pregnancy complications and what should treatment of pregnant women with allergies look like? What do allergies look like in pregnancy?

What are allergies during pregnancy?

Allergy is defined as a type of hypersensitivity of the immune system to factors (allergens) fully tolerated by healthy people. Sources of such inadequate immune cell response include:

  • Plant pollen - for example trees, grasses or fungi (especially mold).
  • foods - many people are allergic to seafood, nuts, cow's milk.
  • Living organism - animal hair, house dust mites, or hymenoptera insects have great allergenic potential.
  • Other substances - mainly drugs (especially from the penicillin group) and latex.

How do allergies appear in pregnancy?

An allergic reaction is characterized by two consecutive phases. The first is an immediate allergic reaction. It develops a few minutes after contact with an allergen and may manifest as itching, sneezing, watery eyes, hives on the skin, abdominal pain, nausea, vomiting, larynx spasm, bronchus, wheezing, or shortness of breath. Importantly, these symptoms are short-lived and disappear spontaneously after cessation of contact with the allergen.

In extreme cases, an immediate allergic reaction may take the form of anaphylactic shock with a sudden drop in pressure, difficulty breathing and impaired consciousness. This condition is a direct threat to life and requires immediate, intramuscular (in the outer surface of the thigh) supply of 0.5 milligrams of adrenaline. This procedure is also absolutely recommended for pregnant and lactating women.

30 to 40% of allergy sufferers develop a so-called late allergic reaction (for example, chronic nasal blockage). Compared to the immediate response, it lasts much longer, is more difficult to treat and requires long-term pharmacotherapy.

Allergy treatment during pregnancy

Effective treatment of allergic diseases in pregnant women requires close cooperation between the patient herself, the gynecologist and the allergist. In the first trimester of pregnancy, if possible, non-pharmacological therapy should be sought. Mainly talking about avoiding factors causing or exacerbating symptoms. Such action relieves the symptoms, improves the comfort of life without pharmacological interventions and reduces the likelihood of a negative impact of the disease on the child's condition and the course of pregnancy itself. What's more, some pregnant women may also benefit from psychological help focused on ways to fight stress (stress may aggravate the symptoms of allergic diseases).

Pharmacotherapy of allergies during pregnancy and breastfeeding

As we have already mentioned in the previous paragraph, non-pharmacological interventions are the basis for the treatment of allergic diseases. In some patients, however, it may be necessary to include pharmacological agents.

Available data show that the majority of medicines used to treat allergic diseases do not show special adverse effects on pregnant women. However, these measures have never been tested on pregnant women and fall under the FDA's so-called category B or C. This means that they can be given to pregnant women only in certain cases, at the explicit recommendation of a doctor. Their independent supply, even if they belong to a group of over-the-counter medicines, is not recommended, and may even be dangerous for a mother and her unborn child.

Conducting pregnancy is a separate issue allergen immunotherapy commonly called desensitization. It seems to be relatively safe for pregnant women (except in cases of shock that may occur during IA). Therefore, it is recommended to continue at the same or lower dose during pregnancy, if it was started earlier. This recommendation applies only to IA aeroallergens, i.e. airborne allergens.

All in all, allergic diseases are not an obstacle to having your own offspring. However, it should be remembered that their treatment may be difficult during pregnancy and require more attention from doctors and the patient herself.

Bibliography:Internal Szczeklik 2018/19