Itchy eyes, sore throat: How to manage allergies and asthma during pregnancy

This article is authored in part by Matthew Feldman, M.D.

April showers bring May flowers – and allergies for 50 million people in the United States. Spring is the peak of allergy and asthma season for many patients. The severity of seasonal allergy symptoms can range from hardly noticeable, to annoying, to intolerable without medication or other treatment.

To make matters worse, symptoms can become more severe during pregnancy. When not controlled, allergies and asthma can lead to the need for antibiotics or steroids, which might cause health problems for a woman and her baby. Let’s discuss what women should know about seasonal allergies and asthma during pregnancy and what they can do to relieve symptoms safely.

How pregnancy affects allergies and asthma

Seasonal allergies occur when the body’s immune system overreacts to certain otherwise common environmental substances, such as pollen and dust. When people with allergies breathe in such a substance – which for them is an allergen – their bodies see it as a foreign invader and mounts an immune response. When this happens, the body produces multiple inflammatory chemicals which can cause classic allergic reactions, such as:

• Inflammation and swelling of the sinuses

• Itchy, watery eyes

• Sinus congestion

• Sneezing

• Sore, itchy throat

• Runny nose

Antihistamines and saline nasal spray can help can help control mild symptoms, while moderate to severe allergies require other therapies, such as nasal steroid sprays.

Asthma and seasonal allergy symptoms may worsen, improve, or remain unchanged during pregnancy. We can’t predict exactly how a pregnant woman’s body and hormonal changes alter how the immune system reacts to foreign substances. For example, pregnancy induces swelling of the nasal mucosa, the inner lining of the nose. Inflammation can lead to pregnancy rhinitis, or nasal congestion and a runny nose during pregnancy. Although the cause of pregnancy rhinitis is related to hormone production and not allergens, this condition may make pre-existing seasonal allergy symptoms worse. Together, these symptoms can make someone pretty miserable and impact nutrition, stress, sleep, and general comfort.

What pregnant women can do

Pregnant women have many options for controlling allergy symptoms. The first step is to be proactive. Ideally, if a woman typically suffers from seasonal allergies, she should talk to her doctor about starting a medication before symptoms begin. If she notices seasonal allergy symptoms for the first time during pregnancy, she should visit her doctor to determine the cause and manage symptoms, which can reduce the risk of a sinus infection.

Mild allergies

For mild allergies, patients can start with first-line defenses, such oral antihistamines or nasal irrigation. Nasal irrigation involves putting saline solution in one nostril and washing out mucus and allergens. I also recommend those with asthma to use prescribed inhalers. Patients also might try changing their bedding more frequently to reduce reactions to dust and pollen she and her partner bring to bed.

Moderate to severe allergies

Steroid nasal sprays are effective and safe for to reduce inflammation that can cause nasal congestion. Immunotherapy, or allergy shot therapy, also can be effective for asthma and seasonal allergies. This therapy teaches the immune system to be less responsive to allergens over time.

Some women worry that taking their regular allergy or asthma drugs will endanger their pregnancy, so they decrease or quit taking their medications. However, the risk is very low, and severe seasonal allergies can lead to sinus or ear infections that require oral steroids or antibiotics – medications that pose a slightly higher risk to developing babies.

Allergy management is important for women who are pregnant or planning to become pregnant. With a doctor’s help, patients can safely control their seasonal allergy symptoms and enjoy the changing seasons again. 

To schedule an appointment, call 214-691-1330 for Allergy and Immunology or 214-645-8300 for Obstetrics and Gynecology.