Allergy and Asthma Medication Use in Pregnancy: Safety and Clinical Considerations

Asthma and allergic diseases are highly prevalent among pregnant women, and inadequate control is associated with increased risks of adverse maternal and fetal outcomes. Importantly, concerns about drug safety often result in therapeutic hesitation and undertreatment. This review summarizes the latest evidence on the pharmacological and safety considerations of asthma and allergy therapies during pregnancy. First, we describe the physiological changes of pregnancy, including alterations in the respiratory, cardiovascular, gastrointestinal, and renal systems, that significantly affect drug pharmacokinetics and pharmacodynamics. Second, we assess the safety profiles of commonly used therapies, including inhaled corticosteroids, long-acting β-agonists, long-acting muscarinic antagonists, systemic corticosteroids, and biologic agents. Finally, we highlight the importance of self-management, asthma action plans, multidisciplinary coordination, and shared decision-making. All of these approaches improve adherence, disease control, and outcomes in pregnant women with asthma.