Pali-Schöll Isabella, Namazy Jennifer, Jensen-Jarolim Erika
Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Veterinärplatz 1, 1210 Vienna, Austria.
Institute of Pathophysiology and Allergy Research, Center of Physiology, Pathophysiology and Immunology, Medical University Vienna, Vienna, Austria.
World Allergy Organ J. 2017 Mar 2;10(1):10. doi: 10.1186/s40413-017-0141-8. eCollection 2017.
Every fifth pregnant woman is affected by allergies, especially rhinitis and asthma. Allergic symptoms existing before pregnancy may be either attenuated, or equally often promoted through pregnancy. Optimal allergy and asthma diagnosis and management during pregnancy is vital to ensure the welfare of mother and baby. For allergy diagnosis in pregnancy, preferentially anamnestic investigation as well as in vitro testing should be applied, whereas skin testing or provocation tests should be postponed until after birth. Pregnant women with confirmed allergy should avoid exposure to, or consumption of the offending allergen. Allergen immunotherapy should not be initiated during pregnancy. In patients on immunotherapy since before pregnancy, maintenance treatment may be continued, but the allergen dose should not be increased further. Applicable medications for asthma, rhinitis or skin symptoms in pregnancy are discussed and listed. In conclusion, i) allergies in pregnancy should preferentially be diagnosed in vitro; ii) AIT may be continued, but not started, and symptomatic medications must be carefully selected; iii) management of asthma and allergic diseases is important during pregnancy for welfare of mother and child.
每五名孕妇中就有一人受过敏影响,尤其是鼻炎和哮喘。怀孕前就存在的过敏症状可能会减轻,或者同样常见地会因怀孕而加重。孕期进行最佳的过敏和哮喘诊断及管理对于确保母婴健康至关重要。对于孕期过敏诊断,应优先采用问诊调查以及体外检测,而皮肤试验或激发试验应推迟至产后进行。确诊过敏的孕妇应避免接触或食用引发过敏的过敏原。孕期不应开始进行过敏原免疫治疗。对于怀孕前就开始接受免疫治疗的患者,可以继续维持治疗,但过敏原剂量不应再增加。文中讨论并列出了适用于孕期哮喘、鼻炎或皮肤症状的药物。总之,i)孕期过敏应优先通过体外诊断;ii)可以继续进行变应原特异性免疫治疗(AIT),但不应开始,且必须谨慎选择对症药物;iii)孕期哮喘和过敏性疾病的管理对母婴健康很重要。