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Pregnancy and H1N1 (swine) flu

 

Definition

During pregnancy, a woman's immune system does not respond as well to infections, making you more susceptible to diseases such as H1N1 (swine) flu.

You’re more likely than women your age who are not pregnant to become very ill if you contract swine flu. Therefore, you need to take special precautions to ensure you stay healthy during the flu season. This article will provide you with information about swine flu and pregnancy.

This is not a substitute for medical advice from your doctor. If you think you have the swine flu, you should contact your doctor’s office immediately.

Information

WILL I HAVE DIFFERENT SYMPTOMS BECAUSE I'M PREGNANT?

The usual symptoms are the same for pregnant women as for others with the flu and include:

  • Cough, sore throat, runny nose and a fever of 100 °F or above
  • Other symptoms may include body aches, headache, fatigue, vomiting and diarrhea

SHOULD I GET THE SWINE FLU VACCINE IF I'M PREGNANT?

For the same risks described above, if you are planning to become pregnant or are pregnant you should receive the swine flu vaccine. In fact, the Centers for Disease Control and Prevention (CDC) considers pregnant women to be at higher risk of contracting swine flu. They are therefore first in line when vaccine supplies are limited.

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

While getting a "normal or mild" case of the flu is not necessarily harmful to mother or child, the true benefit or risk reduction is in preventing uncommon but severe cases that can harm mother and baby.

There are two types of swine flu vaccines. One is given as a shot; the other is a nasal spray.

  • The swine flu shot contains killed (inactive) viruses. It is given with a needle, most often in the arm. It is not possible to get the flu from this type of vaccine. This type of vaccine is recommended for pregnant women.
  • A nasal spray-type swine 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. Nevertheless, if you have concerns about mercury, all of the routine vaccines are also available without added thimerosal. The CDC advises pregnant women to get flu shots either with or without thimerosal.

WHAT ABOUT SIDE EFFECTS OF THE VACCINE?

The most common side effects after flu shots are mild, such as the area where the shot is given being sore and tender or red and swollen. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, 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 contact your doctor.

WHAT ABOUT THE SEASONAL FLU VACCINE? SHOULD I GET BOTH?

If you have not had the regular flu shot, get that also. The regular flu shot is the one you hear about every year.

The shot to prevent the regular flu is different from the swine flu shot.

WHERE CAN I GET THE VACCINE?

Check with your doctor or local pharmacist.

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 influenza-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 meds 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 MEDICAITONS 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 this and 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.

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

Many cold medicines you can buy without a prescription contain more than one drug. Some of these drugs may be safer than others, but none are proven 100% safe. In general, it is best to avoid these drugs if possible, especially during the first 3 - 4 months of pregnancy.

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

COULD SWINE FLU AFFECT MY DEVELOPING BABY?

Some pregnant women who become more ill with swine flu have had early labor and severe pneumonia. Some have died.

IF I'VE BEEN EXPOSED TO SOMEONE WITH THE DISEASE, SHOULD I TAKE AN ANTIVIRAL DRUG?

Close contact with someone who has, or likely has, swine flu increases your risk of the swine flu. Close contact means eating or drinking with the same utensils, caring for children, having intimate or sexual contact, or being exposed to nasal or oral droplets or secretions.

Because you are pregnant, there is a risk of having a more severe case if you do contract the flu. Because of this risk, you should talk to your doctor.

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

There are many things you can do to help protect yourself and your unborn child from swine flu. You should avoid sharing food, utensils, or cups with others. Avoid touching your eyes, nose, and throat, and carry hand sanitizer with you and use it often during the day.


Review Date: 11/3/2009
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, 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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