Research shows reluctance among obstetricians to refer pregnant patients to allergy specialists

Many pregnant women experience allergies, asthma, or reactions to medications - conditions that can affect both mother and baby if not carefully managed. Yet new research presented at the 2025 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting suggests a reluctance among obstetricians to refer their pregnant patients to allergy specialists, even when a referral could help improve care.

The study surveyed obstetricians at a large academic medical center. It found that while nearly all the doctors cared for pregnant patients in both clinics and hospitals, about one in four never referred a patient to an allergist, and almost half referred only once a year.

Referrals most often happened for suspected drug allergies, followed by hives (urticaria) and asthma. Many of the obstetricians surveyed said they didn't always know when to refer to a specialist, and others cited long wait times for appointments as a barrier. Most said they wanted clearer guidelines and more education about managing allergies in pregnancy.

Pregnancy can change how a woman's immune system reacts to allergies or asthma. An allergist can help confirm true allergies, guide safe medication use, and create a care plan that supports both maternal and fetal health."

Miriam Al-Saedy, MD, Internal Medicine resident, lead author of the study and ACAAI member

Says allergist Kelly Colas, DO, PhD, co-author of the study and ACAAI member, "If you're pregnant and living with allergies, asthma, or a past allergic reaction to a drug, you should talk to your obstetrician about whether seeing an allergist might help." Dr. Colas says an allergist can:

• Confirm or rule out medication allergies so you can safely take what you need during pregnancy.
• Help control asthma to keep both you and your baby breathing easier.
• Manage hives, eczema, or other allergic conditions safely with treatments appropriate for pregnancy.
• Work closely with your OB to coordinate your care before, during, and after delivery.

"Allergy and immunology care in pregnancy is safe and can make a real difference in how women feel," said Dr. Al-Saedy. "Don't hesitate to ask for a referral if you think you need one."

Abstract title: Barriers to Allergy and Immunology Referral in Pregnancy: A Survey of Obstetric Physicians

Presenter: Miriam Al-Saedy, MD