Wednesday, May 29, 2002

Pregnant allergy sufferers: Suffer no more

This is the season when my pregnant patients have an abundance of questions regarding how their sinus medications may affect their pregnancies.

There are some who avoid taking any kind of medication during pregnancy and truly suffer through allergy season. Others continue to take their medications but feel constant guilt that they have, somehow, "failed" their unborn baby. The truth is, the vast majority of over-the-counter, as well as prescription allergy medications, taken at the prescribed dosage, are safe during pregnancy and do not present additional undue risk to the fetus.

Pregnancy is broken down into three phases, or trimesters. The first trimester, lasting from conception until the 13th week, is the most important phase for organ formation. The second trimester is noted for fetal growth and the third for further growth and lung maturation.

Since the vast majority of problem pregnancies stem from events which occurred during the first 13 weeks, anything that Mom-to-be is exposed to may take on extra added importance. This is why, in general, doctors recommend no medications (with exception to a pre-natal vitamin) during pregnancy unless absolutely necessary.

Simply put, most common allergy medications on the market are divided into two classes: decongestants and antihistamines.

Examples of decongestants are Sudafed, Actifed and Entex. Decongestants work by slowing down mucus production and opening nasal passages. Side effects include increased blood pressure.

There are many antihistamines, such as Allegra, Benadryl, Claritin, Tavist and Zyrtek. Antihistamines work by blunting the body's response to "allergens" like pollen, dust, etc. Side effects can include drowsiness.

Most over-the-counter cold and allergy medications are a combination of both decongestant and antihistamine. Look at the list of active ingredients on the back of any over-the-counter medication and you will see a dizzying array of completely unpronounceable words. These merely represent the combinations.

Overall, antihistamines have not been shown to be harmful during pregnancy. Decongestants, however, have been associated with physical defects noted in the offspring of laboratory rats who had been exposed to levels of drug that far exceeded the recommended dosage.

Although no one has proven that decongestants cause problems with human fetuses, it is advised that pregnant women use these medications only if necessary, and no more than the recommended dosage. If you have specific questions about your medication, ask your physician.

Pregnancy can be long and uncomfortable, much like Georgia allergy season. Fortunately, most allergy medications will relieve your symptoms and not harm your unborn child. Using both antihistamines and decongestants with caution and within the recommended dosages will help expectant mothers breathe more easily.

Audrey F. Miller,

M.D., FACOG

Peachtree City

Obstetrics and Gynecology