Pregnancy and the flu

During pregnancy, it is harder for a woman's defense (immune) to fight infections. This makes a pregnant woman more likely to get the flu and other diseases.

Pregnant woman are more likely than other non-pregnant women their age to become very ill if they get the flu. If you are pregnant, you need to take special steps to stay healthy during the flu season.

This article gives you information about the flu and pregnancy. It is not a substitute for medical advice from your doctor. If you think you have the flu, you should contact your doctor’s office immediately.

Information

WHAT ARE THE SYMPTOMS OF FLU DURING PREGNANCY?

Flu symptoms are the same for everyone and include:

  • Cough
  • Sore throat
  • Runny nose
  • Fever of 100 °F or above

Other symptoms may include body aches, headache, fatigue, vomiting, and diarrhea

SHOULD I GET THE FLU VACCINE IF I AM PREGNANT?

If you are pregnant or thinking about becoming pregnant, you should get the flu vaccine. The Centers for Disease Control and Prevention (CDC) considers pregnant women have a higher risk for getting the flu and developing flu-related complications.

Pregnant women who get the flu shot get sick less often, and are very unlikely to get a severe case of the flu that can harm them or their baby.

Getting a mild case of the flu is not necessarily harmful to mother or child. However, the flu shot can prevent uncommon but severe cases of the flu that can harm mother and baby.

Flu vaccines are available at most doctor offices and health clinics. There are two types of flu vaccines. The flu shot and a nose-spray vaccine.

  • The flu shot is recommended for pregnant women. It contains killed (inactive) viruses. You cannot get the flu from this vaccine.
  • The nasal spray-type flu vaccine is not approved for pregnant women.

It is okay for a pregnant woman to be around somebody who has received the nasal flu vaccine.

WILL THE VACCINE HARM MY BABY?

A small amount of mercury (called thimerosal) is a common preservative in multidose vaccines. Despite concerns, thimerosal-containing vaccines have NOT been shown to cause autism or attention deficit hyperactivity disorder.

If you have concerns about mercury, ask your doctor about a preservative-free vaccine. All routine vaccines are also available without added thimerosal. The CDC says pregnant women may get flu shots either with or without thimerosal.

WHAT ABOUT SIDE EFFECTS OF THE VACCINE?

Common side effects of the flu shot are mild but can include:

Redness or tenderness where the shot was given

  • Headache
  • Muscle ache
  • Fever
  • Nausea and vomiting

If these side effect occur, they usually begin soon after the shot and may last as long as 1 - 2 days. If you have side effects that last longer than 2 days you should call your doctor.

HOW DO I TREAT THE FLU IF I'M PREGNANT?

Research and many organizations (the American Academy of Pediatrics, the American Congress of Obstetricians and Gynecologists, and the CDC) recommend treating pregnant women with flu-like illness as soon as possible after they develop symptoms.

  • Testing is not necessary for most people, and health care providers should not wait for results of testing before treating pregnant women.
  • It’s best to start antiviral medications within the first 48 hours of developing symptoms, but they can also be used after this time period. Oseltamivir (Tamiflu) 75-mg capsule twice per day for 5 days is the recommended first choice antiviral.

WILL ANTIVIRAL MEDICATIONS HARM MY BABY?

You may be hesitant to start antiviral medications because you may be worried about the medicines harming your baby. However, it’s important to understand that there are severe risks if you do not get treatment:

  • In past flu outbreaks, pregnant women who were otherwise healthy were more likely than those who were not pregnant to become very sick or even die.
  • This does not mean that all pregnant women will have a severe infection. However, it is hard to predict who may have a severe infection, as women who become more ill with flu will have mild symptoms at first.
  • Pregnant women can become very sick very fast, even if the symptoms are not severe at first.
  • Women who develop high fevers or pneumonia can put their fetus at risk for premature delivery and other harm.

DO I NEED AN ANTIVIRAL DRUG IF I HAVE BEEN AROUND SOMEONE WITH THE FLU?

You are more likely to get the flu if you have close contact with someone who already has it.

Close contact means:

  • Eating or drinking with the same utensils
  • Caring for children who are sick with the flu
  • Having sex or intimate contact
  • Being near the droplets or secretions from someone who sneezes, coughs, or has a runny nose

If you have been around someone who has the flu, ask your doctor if you need an antiviral drug.

WHAT TYPES OF COLD MEDICINE CAN I TAKE FOR THE FLU IF I'M PREGNANT?

Many cold medicines contain more than one type of medicine. Some may be safer than others, but none are proven 100% safe. In general, it is best to avoid cold medicines, if possible, especially during the first 3 - 4 months of pregnancy.

To be safe, talk to your doctor or nurse before taking any cold medicines while you are pregnant.

WHAT ELSE CAN I DO TO PROTECT MYSELF AND MY BABY FROM THE FLU?

There are many things you can do to help protect yourself and your unborn child from flu.

  • You should avoid sharing food, utensils, or cups with others
  • Avoid touching your eyes, nose, and throat
  • Carry hand sanitizer with you and use it often during the day

References

Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM; Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011 Jan 21;60(1):1-24.

American College of Obstetricians and Gynecologists Committee on Obstetric Practice. ACOG Committee Opinion No. 468: Influenza vaccination during pregnancy. Obstet Gynecol. 2010 Oct;116(4):1006-7.

Updated: 4/13/2012

Reviewed by: David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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