• During pregnancy, automatically stopping therapy can be not only unnecessary, but also dangerous
• Especially with asthma, a new management and medication may be necessary
• Gentle medication is generally advantageous, but many medications are no longer a problem during pregnancy

Allergic diseases such as asthma, allergic rhinitis, atopic dermatitis, and allergies affect up to 30% of all women of childbearing age (Pfaller B, et al., 2022). Accordingly, quite a lot of expectant mamas are affected by these problems. Should you be one of them, you will find out everything important you need to know about this topic in this article.

Breathing Safely: Treating Asthma During Pregnancy

Unfortunately, poorly controlled asthma during pregnancy represents a danger to you and your little wonder that should not be underestimated: The risk of developing preeclampsia, i.e., a potentially life-threatening combination of high blood pressure and organ damage during pregnancy, increases significantly due to poor asthma treatment. The risk that you will require a cesarean section or suffer a premature birth also increases due to the inadequate treatment of this disease. Furthermore, your baby is more likely to be too light at birth and not grow sufficiently. Unfortunately, the risk that your little baby will develop asthma themselves can also increase (Pfaller B, et al., 2022).

Now, of course, the question arises as to whether and how asthma may be treated during pregnancy to prevent such consequential side effects: Scientists now agree that standard asthma therapy brings greater benefit than risk during pregnancy. Of course, you should still seek medical advice and not simply experiment on your own, and continue your therapy as before (Kwah, J. H., et al., 2019).

But how exactly should your medication be adapted to your special, new circumstances? To ensure ideal asthma therapy, experts recommend having regular FeNO measurements (measurement of fractional exhaled nitric oxide) performed. FeNO measurements are considered a safe method to diagnose asthma and to determine the severity of the disease or the effectiveness of the therapy. For this reason, this painless measurement is wonderful as a tool to successfully manage the disease even during your pregnancy (Pfaller, B., et al., 2022).

For some women, asthma can also become a problem during labor – however, fortunately, only a few expectant mamas are affected by this. So, if you are worried about an asthma attack during childbirth, scientists recommend relying on sufficient pain medication. If you experience more pain, the chances that you will get an attack increase for various reasons. In the context of childbirth, an epidural (PDA), i.e., a local anesthetic, is considered the most effective method for pain reduction and is recommended for exactly this reason for mamis with asthma as well (Jones, C. E., et al., 2025).

Allergies During Pregnancy

As in the course of the rest of your life, you should avoid (your) allergens as best as you can to avoid risking allergic reactions (Pope, E. M., et al., 2023). This applies to classic pollen allergies as well as to food allergies and contact allergies. While this is largely feasible for food and contact allergies, it is unfortunately virtually impossible to escape pollen, house dust, and Co. Especially modern antihistamines, however, are considered harmless during pregnancy and could therefore be your rescue (Pfaller, et al., 2022). Here, too, we urgently recommend that you consult with your doctor.

If you are not sure whether or from which allergy you suffer, pregnancy is definitely not an appropriate time to find out. For this reason, allergy tests are sometimes not even carried out during pregnancy. Even if they are carried out, it should be critically questioned during this magical time whether the test is actually necessary right now or could not be done at a later date instead (Pope, E. M., et al., 2023).

Atopic Dermatitis and Eczema in Pregnancy: From Basic Care to Cortisone to Biologics

Atopic dermatitis, also known as neurodermatitis, should ideally be well under control even before pregnancy. Finding the ideal care for one's own skin can indeed take time, and in case of failed attempts, entail the need to use stronger active ingredients. However, these stronger active ingredients should be avoided during pregnancy if possible – on the one hand, because they are not all considered safe, and on the other hand, because the side effects of substances like cortisone can occur more intensely (Pope, E. M., et al., 2023).

You should by no means neglect your basic care during pregnancy to prevent flare-ups. Should you nevertheless depend on cortisone creams, you should discuss this with your doctor. Most cortisone ointments can be used without hesitation, however, it may be necessary to adjust the dosage or complementary therapies. If necessary, UVB therapy can also be used during pregnancy. In particularly extreme cases, certain systemic therapies are also allowed for expectant mamas under medical supervision (Pfaller, et al., 2022). Biologics can also continue to be used in many cases during pregnancy. This is partly due to the fact that biologics are usually used in women with particularly severe atopic dermatitis, and these women have more side effects to fear from the disease itself than from the therapy with biologics (Shakuntulla, F., et al., 2022).

The recommendations for eczema look very similar: basic care as the most important tool before local and, if necessary, systemic therapies can take place (Keeling, E., et al., 2025).

Anti-Allergic Medications During Pregnancy

As already mentioned, most antihistamines are considered safe during pregnancy. However, modern preparations of the second generation are to be preferred over older formulations.

There is also the all-clear for asthmatics: Most cortisone inhalers may continue to be used in consultation with a doctor.

Nasal sprays with cortisone, on the other hand, are less well researched than classic inhalable sprays, but in many cases, they should also be unproblematic.

There is sufficient data on immunosuppressants showing that the choice of the right active ingredients is crucial: If a suitable active ingredient is used during pregnancy, no negative surprises are to be expected (Pfaller, B., et al., 2022).

Frequently Asked Questions on the Topic

May I continue to use my asthma inhalers during pregnancy?

Mostly, yes. Scientific studies clearly show that the risk of uncontrolled asthma is much higher than the risk of standard medications. However, always discuss the exact dosage with your doctor.

Which allergy tablets (antihistamines) are allowed for pregnant women?

Modern antihistamines of the so-called second generation are considered well-researched and safe during pregnancy. Nevertheless, you should not take them on your own initiative, but consult with your gynecological or primary care practice.

Does cortisone ointment for atopic dermatitis harm my unborn child?

Most topical cortisone ointments can be used on the skin during pregnancy without hesitation, as only minimal amounts enter the bloodstream. Basic care should nevertheless always be the foundation of the treatment.

What is a FeNO measurement and why is it useful during pregnancy?

The FeNO measurement is a simple, painless breath test that measures nitric oxide in the exhaled air. It helps to precisely monitor the inflammation level in the airways and perfectly adapt the asthma medication to your pregnancy.

References

• Pfaller, B., Bendien, S., Ditisheim, A., & Eiwegger, T. (2022). Management of allergic diseases in pregnancy. Allergy, 77(3), 798–811. https://doi.org/10.1111/all.15063
• Kwah, J. H., & Stevens, W. W. (2019). Asthma and allergies in pregnancy. Allergy and asthma proceedings, 40(6), 414–417. https://doi.org/10.2500/aap.2019.40.4260
• Jones, C. E., & Jamil, Y. (2025). Management of asthma in pregnancy. Clinical medicine (London, England), 25(1), 100277. https://doi.org/10.1016/j.clinme.2024.100277
• Pope, E. M., Laageide, L., & Beck, L. A. (2023). Management of Allergic Skin Disorders in Pregnancy. Immunology and allergy clinics of North America, 43(1), 117–132. https://doi.org/10.1016/j.iac.2022.05.012
• Shakuntulla, F., & Chiarella, S. E. (2022). Safety of Biologics for Atopic Diseases During Pregnancy. The journal of allergy and clinical immunology. In practice, 10(12), 3149–3155. https://doi.org/10.1016/j.jaip.2022.08.013
• Keeling, E., Smith, C. H., & Woolf, R. T. (2025). The management of severe eczema in pregnancy. Clinical medicine (London, England), 25(1), 100282. https://doi.org/10.1016/j.clinme.2024.100282