Allergen immunotherapy in pregnancy.

Area of Science:

• Allergy and Immunology
• Reproductive Medicine
• Maternal-Fetal Medicine

Background:

• Allergic diseases pose significant health risks to pregnant women and their fetuses.
• Effective management of allergies during pregnancy is crucial for reducing adverse maternal and fetal outcomes.
• Allergen immunotherapy (AIT) offers a potential treatment option, but its safety during pregnancy requires careful evaluation.

Purpose of the Study:

• To assess the safety of initiating and continuing allergen immunotherapy (AIT) during pregnancy.
• To evaluate the impact of AIT on the development of atopic diseases in offspring.
• To provide evidence-based guidance for managing allergic conditions in pregnant women.

Main Methods:

• A comprehensive literature review was conducted, searching MEDLINE and Cochrane Library for relevant studies.
• Included were clinical trials, randomized controlled trials, and observational studies published from 1900 to the present.
• Searched terms included "Pregnancy" and "Immunotherapy," yielding studies on AIT continuation, initiation, and effects on offspring atopy.

Main Results:

• Continuation of AIT during pregnancy showed no significant increase in prematurity, hypertension, congenital malformations, or perinatal deaths.
• Initiating AIT during pregnancy did not result in significant maternal or fetal complications.
• Generalized reactions during AIT in pregnancy (10/453 cases) did not lead to fetal complications, and AIT did not alter the risk of atopy in offspring.

Conclusions:

• Continuation of allergen immunotherapy (AIT) during pregnancy is considered safe.
• Initiating AIT during pregnancy appears potentially safe, but further research is necessary for confirmation.
• Current evidence does not conclusively demonstrate that AIT during pregnancy reduces the risk of atopic disease in offspring.