Prenatal Exposure to Drugs and Allergic Diseases in Offspring

ABSTRACT

Recent studies reported increased risks for the development of allergic diseases in children after prenatal exposure to drugs. The mechanisms by which drug exposure may actually cause allergic diseases are not known. It has been suggested that these drugs promote transplacental allergen transfer to the fetus, resulting in the preservation of allergens. If transferred to the fetus, these allergens could induce a Th2-dominant immune response and allergic sensitization of the fetus. The development of the fetal immune system is influenced by the allergic state of the mother. Maternal IgE can cross fetal membranes, and a Th2-dominant phenotype in the mother can promote an allergy-prone phenotype in the fetus. The fetal immune system starts early in development but mainly matures in later trimesters. Maternal use of antibiotics during pregnancy may prove to be a risk factor for persistent wheezing and allergy development in early infancy. Paracetamol exposure during pregnancy was associated with allergic rhinitis, its use until 6 months of age was associated with allergic sensitization and a history of asthma in girls. Exposure to proton pump inhibitors (PPIs) and Histamine 2-antagonists (H2As) has been associated with an increased risk for the development of atopic dermatitis, asthma, allergic rhinitis, and especially with the development of multiple allergic diseases. Our reviews showed it is necessary to prescribe such drugs under the consultation of an expert physician and to try and reduce exposure as much as possible to prevent offspring allergies in the case of mothers with a history of allergic diseases.