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Allergen immunotherapy in pregnancy.

Paul Oykhman1, Harold L Kim2, Anne K Ellis3

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Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
|November 13, 2015
PubMed
Summary

Allergen immunotherapy (AIT) continuation during pregnancy is safe for mothers and babies. While initiating AIT in pregnancy may also be safe, more research is needed. AIT does not appear to prevent atopic disease in offspring.

Keywords:
Allergic rhinitisAllergyAsthmaImmunotherapyPregnancy

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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.