ANAPHYLAXIS AND INSECT ALLERGY: Edited by Gianenrico Senna and Mariana CastellsPregnancy and Hymenoptera venom allergyBonadonna, Patriziaa; Mauro, Marinab; Preziosi, Donatellac; Pravettoni, ValeriodAuthor Information aAllergology Integrated University-Hospital of Verona, Verona bAllergology ASST Lariana Sant’Anna Hospital, Como cDepartment of Internal Medicine, Allergy Unit, Sondrio Civil Hospital, Sondrio dAllergy Outpatients, IRCCS Foundation Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy Correspondence to Patrizia Bonadonna, MD, USD, Universitaria Integrata of Verona, Verona, Italy. Tel: +39 0458126185; e-mail: email@example.com Current Opinion in Allergy and Clinical Immunology: October 2020 - Volume 20 - Issue 5 - p 465-469 doi: 10.1097/ACI.0000000000000681 Buy Metrics Abstract Purpose of review To evaluate the indication to perform venom immunotherapy (VIT) during pregnancy considering the risks of adverse events during the build-up phase or the maintenance phase and analyzing specific articles and guidelines on VIT. Recent findings Only few studies treat this argument and literature only counts one recent study on the topic, whereas recent guidelines state the behavior to keep in pregnancy. Summary Hymenoptera venom allergy (HVA) affects about 7.5% of the European population. VIT is the only effective disease-modifying treatment for patients presenting anaphylactic reactions. VIT counts several mechanisms of action, with the increase of IgG1 and IgG4 and a cytokine impairment inducing a Th2–Th1 shift. Pregnancy is a health condition where a Th2 profile is required to prevent fetal rejection, so VIT could be a problem for the fetus when started during pregnancy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.