Obstetricians Rarely Refer Pregnant Patients with Allergies to Specialists, Study Finds
Pregnant patients frequently experience allergic or immunologic conditions such as asthma,urticaria,or drug allergies,which can have implications for both maternal and fetal health outcomes. However, a new study presented at the 2025 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting found that obstetric physicians infrequently refer pregnant patients to allergy and immunology (A/I) specialists, despite the availability of safe and beneficial consultation.1,2
The study, Barriers to Allergy and immunology referral in Pregnancy: A Survey of Obstetric Physicians, assessed referral practices and perceived obstacles among clinicians managing pregnant patients at a large academic medical center.A 20-question cross-sectional survey was distributed to attending physicians, fellows, and residents to evaluate experience, comfort level with allergic conditions, frequency of referrals.
Takeaways
* Nearly 1 in 4 obstetric physicians never refer pregnant patients to an allergist, and most refer rarely.
* Limited knowledge about referral indications and long wait times are key barriers.
* Educational guidelines and institutional support could improve allergy care in pregnancy.
Allergy Care During Pregnancy Often Underutilized, Study Finds
A recent study highlights a gap in care for pregnant women with allergies and asthma, revealing that many obstetric physicians feel unprepared to manage allergic conditions and are hesitant to refer patients to allergy and immunology (A/I) specialists. The study, presented at the 2025 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting, underscores the importance of collaborative care for optimal maternal and fetal health.
The research, based on a survey of obstetric physicians, found that a significant number perceive barriers to referral, including uncertainty about when a referral is necessary and a lack of readily available institutional guidance. Many respondents (76%) expressed a desire for institutional guidelines, while 72% requested provider resources and 64% were interested in educational workshops to improve their confidence in allergy management.
How can allergy care benefit pregnant patients?
Pregnancy can alter a woman’s immune system, potentially changing how she reacts to allergies or asthma. Effective management of these conditions during pregnancy is crucial. Collaboration between obstetricians and allergists can reduce risks associated with uncontrolled asthma, inappropriate avoidance of necessary medications, or untreated allergic reactions.
“Allergy and immunology care in pregnancy is safe and can make a real difference in how women feel,” said Miriam Al-Saedy, MD, an internal medicine resident and ACAAI member, and lead author of the study. “Don’t hesitate to ask for a referral if you think you need one.”
Kelly colas, DO, PhD, an allergist and ACAAI member, explained the specific benefits of consulting an allergist during pregnancy: confirming or ruling out medication allergies to ensure safe treatment, controlling asthma for easier breathing for both mother and baby, and safely managing conditions like hives and eczema with pregnancy-appropriate treatments. She emphasized the importance of coordinated care, stating that allergists can “work closely with your OB to coordinate your care before, during, and after delivery.”
What are the next steps for improving allergy referral practices?
The researchers suggest that targeted educational programs and the development of institutional guidelines could significantly improve physician confidence and streamline access to A/I specialists. Specifically, they reccommend establishing local referral pathways, integrating allergy management guidance into standard obstetric protocols, and raising awareness about the benefits of allergy and immunology consultation.
As Dr. Al-Saedy summarized, an allergist can provide valuable support by confirming allergies, guiding safe medication use, and developing a thorough care plan that prioritizes both maternal and fetal well-being.
References:
- American College of Allergy, Asthma, and Immunology. Pregnant women frequently enough miss out on specialist allergy care. Eurekalert. November 6, 2025. Accessed november 12,2025. https://www.eurekalert.org/news-releases/1103523
- Al-Saedy M, Colas K. BARRIERS TO ALLERGY AND IMMUNOLOGY REFERRAL IN PREGNANCY: A SURVEY OF OBSTETRIC PHYSICIANS.Abstract.Presented at: 2025 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting. Orlando, Florida.