Breathing is arguably the most important thing you’ll do today. And if you’re pregnant, a healthy set of lungs is critical to make sure your growing baby gets the oxygen they need, and also to help you breathe out the excess carbon dioxide that your baby needs to eliminate. You’re breathing for two, now! Just like the rest of your body, your respiratory system goes through remarkable changes during pregnancy for this specialized air exchange. You may notice that your diaphragm (the muscle at the base of your lungs) rises up to make room for your expanding uterus, and your rib cage spreads out to the sides to allow you to breathe normally.

Even with these changes, it’s easy to be short of breath in pregnancy. You’ll likely also notice more nasal congestion caused by pregnancy hormones.

Allergies in Pregnancy

If you’re pregnant and have seasonal allergies or asthma, you may be asking yourself a few questions:

  • How do allergies or asthma affect my pregnancy?
  • Will pregnancy make my allergies or asthma worse? Is it safe to take allergy or asthma medications during pregnancy?

Controlling asthma and allergy symptoms is essential so that you and your baby get the oxygen you both need to prevent pregnancy complications. Experts know that poorly controlled asthma can increase baby’s risk for birth defects of malformations, preterm birth, growth restriction (a too-small baby), and a longer hospital stay for baby.

Uncontrolled allergies or asthma can also increase your risk for developing high blood pressure (like pre-eclampsia), problems with the placenta, needing a cesarean surgery, and a longer hospital stay. Your provider may need to monitor you and your baby more closely during your pregnancy to make sure you are not developing any of these complications.

Common Allergy & Asthma Symptoms in Pregnancy

Research shows how you experience allergies and asthma falls into three categories:

  • One-third of moms find their symptoms improve
  • One-third of moms say symptoms get worse
  • One-third of moms say the symptoms stay the same

If your symptoms continue or get worse during pregnancy, continue to take your medication and avoid things that make your symptoms worse.

Be sure to review your medical history and all your medications with your healthcare provider so that you can work together to find the best treatment options for your allergies and asthma symptoms during pregnancy, so you can make an informed decision about your care.

Common Asthma Medication

Most prescribed asthma medication can and should be continued during pregnancy. Sometimes long-acting beta2-agonists may be needed if the short-acting medications don’t provide good control of asthma symptoms.

Short-acting beta2-agonists, like albuterol inhalers or inhaled corticosteroids, like Budesonide (which is considered first-line therapy for asthma in pregnancy) are safe in pregnancy.

There’s limited research on the use and safety of leukotriene modifiers like montelukast, zafirlukast, and zileuton in pregnancy. If you’re taking one of these, talk with your care provider to see if one of the other medications listed might work for you instead.

Common Allergy Medications

Most over-the-counter antihistamines like chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), loratadine (Claritin), and cetirizine (Zyrtec) are safe in pregnancy. Cromolyn and fluticasone (Flonase Allergy) nasal sprays are also safe in pregnancy.

However, the antihistamine fexofenadine (Allegra) shouldn’t be taken in pregnancy, and
oral decongestants like pseudoephedrine (Sudafed)
and phenylephrine should also be avoided.

Allergy shots aren’t usually started during pregnancy, but if you already receive them and feel that they’re helpful, you can continue to take them during pregnancy at the same dose you were receiving before becoming pregnant.

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By Jamie Vincent, MSN, APRN-CNS, RNC-OB, C-EFM
Author

Jamie Vincent, MSN, RNC-OB, C-EFM, is a nurse expert adviser to Healthy Mom&Baby.

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