Handling Asthma & Allergies During Pregnancy

Content medically reviewed by Laura Knutson, MD

What does it mean for you (and your baby) to have asthma or allergies during pregnancy? It's a question on many expecting moms' minds—and Essentia Health OB/GYN Dr. Laura Knutson is here to address it.

"For some women, allergies and asthma may worsen during pregnancy," Dr. Knutson said. "Many over-the-counter and prescription allergy and asthma medications are safe to use while pregnant. Your prenatal care provider can help you manage your symptoms."

Why Is Controlling Asthma & Allergies During Pregnancy Important?

Your baby’s health is tied to yours, and uncontrolled allergies or asthma can affect both of you. Allergy symptoms, such as itchy, watery eyes and a stuffy nose, can make asthma worse. Allergies can also lead to pregnancy rhinitis, a temporary condition that can include runny nose, sneezing, and other allergy symptoms.

During pregnancy, you’re breathing for two. Your baby depends on you to bring in enough oxygen for both of you. Asthma flare-ups can make this difficult. Without a steady supply of oxygen reaching the baby through your blood, there is an increased risk of growth or development problems. Uncontrolled asthma can lead to blood pressure problems, premature birth, and other pregnancy complications, according to Dr. Knutson.

“The severity of asthma before pregnancy is a good predictor of the severity of asthma during pregnancy,” she said. “This means if asthma is already poorly controlled, it’s more likely to become worse throughout the course of pregnancy. Worsening tends to happen in the third trimester.”

Pregnancy-related factors can contribute to asthma getting worse, Dr. Knutson said. These factors include a higher metabolism, which requires more oxygen, and enlargement of the uterus, which presses against the organs and tissues above it. This reduces lung capacity.

Controlling Symptoms: Medications & More Medications

are the cornerstones of managing asthma and allergies during pregnancy. Talk with your prenatal care provider about your allergy medicine before you conceive. They can identify which medications are safe to use. In more severe cases, a patient can see an allergist or pulmonologist.

Common over-the-counter antihistamines are safe to use during pregnancy, but consult your medical provider before taking them. Options include –

• Cetirizine (Zyrtec)
• Chlorpheniramine (ChlorTrimeton)
• Diphenhydramine (Benadryl)
• Hydroxyzine (Atarax)
• Loratadine (Claritin)

Some steroid nasal sprays, saline nasal sprays, and nasal strips may be safe to use during pregnancy, although it’s best to get the green light from your prenatal care provider first. You should also ask them before using a decongestant. In some cases, these medications can cause complications in expecting moms and babies, according to the American College of Allergy, Asthma, & Immunology.

It’s safe to continue receiving allergy shots during pregnancy if you were using them before conceiving. It’s not advisable, however, to start this treatment while pregnant.

“Another important element is avoiding symptom triggers,” Dr. Knutson said. “Try to avoid cigarette smoke, pollen, animal dander, or any other specific triggers.” 

Talking Asthma & Allergies During Pregnancy

If you have asthma or allergies, discuss them—and the medications you take— with your prenatal care provider early in your first trimester. Even better, have the conversation as part of planning for a healthy pregnancy.

“Don’t stop taking your medications unless your medical team advises it,” Dr. Knutson said. “Good medical care and safe medication use are important for a safe and healthy pregnancy.”