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Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its Effects on Asthma & Allergies

Pregnancy and its associated changes may affect either your asthma or rhinitis, or both. Should you become pregnant please notify your OAAC physician as soon as possible. This will allow us to work closely with the physician providing your obstetrical care. A team approach to the assessment and care of the pregnant allergic patient will result in the best care for your condition.

Remember, the final decisions on your medications and treatments are always made by the physician providing the obstetrical care. However, your OAAC physician should follow your asthma closely during the pregnancy. We can provide advice about continuation or discontinuation of treatments you are already on for your allergy/asthma prior to the pregnancy.

Allergy Immunotherapy (Shots)

There is no reason to discontinue immunotherapy during pregnancy. It does not pose a risk to the development of your baby. However, we do not want to present an increased risk for systemic reaction during the pregnancy.

Therefore all immunotherapy during a pregnancy must be at a stable or maintenance dose. We do not build or increase the dose of your shots during pregnancy. If you are on build-up of your immunotherapy and you become pregnant, contact your OAAC provider immediately to discuss how to proceed. If you are on your maintenance dose and are having symptoms from the injections or other concerns, contact your OAAC provider.

Rhinitis (Nasal Symptoms)

Your nasal allergy symptoms may improve (15%), worsen (34%) or stay unchanged (46%) during your pregnancy. Some patients develop unrelated non-allergic nasal congestion (rhinitis of pregnancy) during the second half of their pregnancy. If you are having problems please contact your OAAC physician. Some medications are considered safer than others during pregnancy. Non-medical approaches like saline nasal rinses and external nasal dilator strips are very safe.

Asthma

Asthma symptoms during pregnancy appear to worsen, improve or remain unchanged in roughly equal proportions (1/3, 1/3, 1/3). This means that some patients with even very mild asthma may develop more severe symptoms when pregnant. The period of greatest increased incidents of increased symptoms is the third trimester (2436 weeks).

Since the well-being of the baby depends on the severity of the asthma in the mother, close monitoring is necessary. We want to work with your obstetrical physician to maintain your asthma control with the least amount of medications possible. However, because uncontrolled asthma presents the greatest risk to the baby (versus drug side effects) it is imperative not to discontinue or change your asthma medications without the consultation of your OAAC physician. Inhaled steroids for example are considered safe and effective in pregnancy.

Recent News

REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE
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REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE

The study, published in the AAAAI’s journal The Journal of Allergy and Clinical Immunology: In Practice, reports findings for participants who received a follow-up oral food challenge after one year on peanut daily maintenance.

MILWAUKEE, WI – Data published in The Journal of Allergy and Immunology: In Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI), demonstrated that peanut oral immunotherapy (OIT) is effective after one year of maintenance in preschool participants who received a follow-up oral food challenge (OFC).

Preschoolers (9-70 months old) enrolled in the real-world study were administered increasing peanut doses in a clinic every two weeks over 8-11 visits until reaching the 300mg peanut protein maintenance dose. After spending approximately 12 months taking maintenance doses, patients were invited to complete a peanut follow-up OFC.

A total of 164 patients completed build-up and three dropped out of maintenance, leaving 161 patients available for follow-up OFC. A total of 117 of the 161 eligible patients received the follow-up OFC. Among them, 92 (78.6%) were able to tolerate a cumulative peanut protein dose of 4,000mg. A total of 115 (98.3%) tolerated a cumulative 1,000mg dose at follow-up, which would protect against accidental peanut exposures.

“The main takeaway for parents is that in this study, OIT provided protection from accidental exposures for 98.3% of preschoolers,” said Lianne Soller, PhD, corresponding author of the study and University of British Columbia allergy research manager. “These data, in combination with our previous data demonstrating safety of peanut OIT in preschoolers, suggest that this therapy could be considered for this age group as an alternative to the current recommendations to avoid peanut.”

Also of note was that epinephrine use during maintenance dosing remained low with only two participants requiring it, and only 10.5% of participants experienced allergic reactions at all. During the maintenance phase, only one patient needed to go to the emergency department due to an allergic reaction.

“Our study is the first to report on effectiveness of peanut OIT in preschoolers in a real-world setting, as opposed to a clinical trial setting,” said Dr. Soller. “We plan to continue to follow-up with this cohort long-term so we can continue to strengthen and solidify our recommendations regarding peanut exposure and oral immunotherapy.”

You can learn more about the current state of oral immunotherapy at the AAAAI’s website, aaaai.org.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

The post REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE appeared first on Oklahoma Allergy and Asthma Clinic.

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