Allergies During Pregnancy: Risks, Management, and Prevention

Pregnancy introduces a complex interplay of physiological and immunological adaptations that significantly influence the course of allergic diseases. This review article synthesizes current understanding of allergies during gestation, focusing on its prevalence, the unique risks posed to both mother and fetus, and evidence-based strategies for diagnosis, management, and prevention. The maternal immune system undergoes a crucial shift towards a Th2-dominant state, essential for fetal tolerance but potentially exacerbating allergic manifestations. Hormonal fluctuations further modulate immune responses, contributing to variable disease courses. Uncontrolled allergic conditions, particularly asthma, are associated with substantial maternal complications such as preeclampsia and increased rates of cesarean delivery, and adverse fetal outcomes including hypoxia, preterm birth, and low birth weight. Diagnosis in pregnancy prioritizes fetal safety, favoring in vitro methods over skin or provocation tests. Management emphasizes a multidisciplinary approach, combining non-pharmacological interventions with carefully selected pharmacotherapies, where the risks of uncontrolled disease generally outweigh those of appropriate medication.